This paper evaluated whether externally designed, evidence-based interventions for improving care for depression can be locally implemented in managed care organizations. The interventions were carried out as part of a randomized trial involving 46 practices within six diverse non-academic managed care organizations. Based on evaluation of adherence to the intervention protocol, the authors determined that local practice leaders are able to implement pre-designed interventions for improving depression care. Adherence rates for most key intervention activities were above 70%, and many were near 100%. Three intervention activities fell short of the goal of 70% implementation and should be targets for future improvement in clinical practice for depression.