Depression and Metabolic Health Intensive Outpatient Program (IOP)
A VBOHC | Oak Mountain Outdoor Healthcare Program
Program Overview
Duration: 12 weeks
Intensity: 3 days per week, ~3 hours/day
Services include:
Individual psychotherapy
Outdoor group psychotherapy
Metabolic screening, lab monitoring, and medication management
Nutritional and movement-based interventions
Trauma-informed, systems-based care (family and relational context)
Care coordination and social needs navigation
Unlike conventional IOPs, this model embeds green and blue space exposure as structured, measurable clinical interventions rather than optional or recreational activities.
Green Space Exposure Includes:
Forested trails
Meadows, parks, and natural open spaces
Outdoor treatment sessions and movement-based groups
Blue Space Exposure Includes (where available):
Lakeshores, rivers, streams, and reflective water environments
Mindfulness and regulation activities conducted near water
The model explicitly measures dose, quality, and equity of environmental exposure as part of clinical care.
Exposure Metrics Include:
Average weekly minutes of structured green space exposure
Average weekly minutes of structured blue space exposure
Type of exposure (walking, therapy session, mindfulness, group activity)
Seasonal variation
Patient-reported perceived safety and accessibility
Outcome Linkages:
Correlation of exposure dose with:
PHQ-9 improvement
HbA1c reduction
Blood pressure changes
Sleep quality
Inflammatory surrogates (where available)
Equity Lens:
Comparison of participant baseline environment access vs IOP-provided exposure
Outcomes stratified by neighborhood deprivation index and rurality
To support CMS learning goals and long-term policy relevance, OMOHC will establish a limited, consent-based clinical biobank embedded within routine care.
The biobank is designed to:
Support implementation science, not exploratory genetics
Examine biological correlates of environment-first interventions
Inform future standardized quality measures
Collected at baseline, discharge, and selected follow-ups:
Blood samples (HbA1c, lipids, inflammatory markers)
Salivary cortisol (stress response)
Optional epigenetic markers related to stress and inflammation
All samples are:
De-identified
HIPAA compliant
IRB-approved
Never used for predictive underwriting or eligibility determinations
Biobank data will be linked to:
Clinical outcomes
Environmental exposure metrics
Utilization and cost data
This allows CMS to evaluate mechanism, not just correlation, while preserving patient protections.
Payment Approach:
Prospective bundled payment per IOP episode
Includes:
Behavioral health services
Medical and metabolic management
Outdoor and environment-based interventions
Care coordination and digital tools
Performance Incentives:
Depression remission/improvement
HbA1c and metabolic improvement
Reduced ED and inpatient utilization
Equitable outcomes across demographic groups
This model shifts payment away from volume-based fragmentation toward condition-informed recovery trajectories.
Methods:
Pre-post outcomes analysis
Matched comparison group using claims and clinical data
Qualitative interviews with participants and clinicians
Primary Outcomes:
Change in PHQ-9
Change in HbA1c
Change in blood pressure and BMI
Secondary Outcomes:
PMPM total cost of care
Hospital and ED utilization
Functional status and patient experience
Environmental exposure dose-response relationships
This demonstration aligns directly with CMS priorities for:
Mental health integration
Chronic condition prevention and management
Health equity
Value-based payment reform
Whole-person care
Evidence-generating models with national scalability
If successful, this model can be:
Replicated in urban, suburban, and rural settings
Deployed through existing health systems
Codified into future CMS benefit and payment guidance
This demonstration positions environment not as an add-on, but as a clinical determinant—measurable, accountable, and financeable within value-based care.
This IOP is structured for:
1115 demonstration alignment
CMMI model-test readiness
Risk-stratified care pathways
Cardiovascular + behavioral health quality measures
Total cost of care reduction