The Urgent Need to Redefine Quality in Behavioral Healthcare
The accessibility of mental health support remains a critical challenge. A shortage of providers coupled with lengthy wait times are notable hurdles, but equally concerning is the difficulty in assessing the quality of the care received. While payers amass significant patient data, translating that data into meaningful insights about care effectiveness proves elusive.
This assessment comes from Dr. Taft Parsons,Chief Psychiatric Officer at CVS Health,speaking at the recent Behavioral Health Tech conference. He argues a fundamental shift is needed: a clearer, universally accepted definition of “good” behavioral healthcare.
Why Defining Quality Matters
Currently, much of behavioral health measurement focuses on process – whether specific tasks where completed. This “did you do a thing?” approach, as dr. parsons puts it, offers an incomplete picture. Consider the commonly used HEDIS measure of follow-up appointments after hospitalization.
While getting a patient seen within seven days can correlate with better outcomes, it doesn’t reveal what happened during that appointment. Was a thorough medication reconciliation performed? Were crucial social determinants of health addressed? Did the clinician take steps genuinely designed to improve the patient’s overall health journey?
The focus must shift from tracking activity to measuring actual patient health improvements. This requires a move beyond simply checking boxes to evaluating demonstrable, positive change.
The Role of Policy and Value-Based Care
Achieving this consensus on quality isn’t simply a matter of industry agreement. Dr. Parsons believes policy intervention is essential.”It’s hard for payers, providers, advocates…to all be on the exact same page,” he explains. “Sometimes the only way that happens is when there is a policy that says we’re going to define it.”
This clearer definition of quality is also crucial for advancing value-based care models. The current ambiguity makes it difficult to construct effective contracts that reward outcomes rather than simply paying for services rendered.When everyone agrees on what constitutes “good care,” collaboration and results-driven payment become significantly easier.
Moving Towards Meaningful Metrics
The current state of affairs hinders progress. Behavioral health lags behind physical health in establishing robust quality metrics. This disparity limits the ability to accurately assess care, implement effective value-based contracts, and ultimately, improve patient outcomes.
Defining quality in behavioral health isn’t just about better data collection; it’s about a fundamental shift in perspective. It’s about prioritizing patient well-being and focusing on measurable improvements in their lives. This requires a collaborative effort, guided by thoughtful policy, and a commitment to moving beyond activity-based measurement towards outcome-focused care.
Frequently Asked Questions about Quality in Behavioral Healthcare
1. What is meant by “quality” in behavioral healthcare, and why is it hard to define?
Defining quality is challenging because it’s ofen subjective and interpretations vary widely among payers, providers, and advocates. Currently, quality is frequently measured by whether certain tasks were completed (like a follow-up appointment), rather than by actual improvements in a patient’s health and well-being.
2. How does the current focus on “doing a thing” impact the quality of mental health care?
This approach provides an incomplete picture of care. Simply verifying task completion doesn’t reveal how those tasks were performed or whether they were effective in addressing the patient’s needs. It overlooks crucial elements like medication reconciliation and addressing social determinants of health.
3. What role does policy play in improving quality assurance in behavioral health?
Dr.Parsons argues that policy intervention is vital for establishing a broad consensus on what constitutes ”good” care.A clear policy definition can provide a framework for payers, providers, and advocates to align their efforts and work towards common goals.
4. How would better quality metrics support value-based care in mental health?
Currently, the lack of standardized quality metrics makes it difficult to create effective value-based contracts. Clearer metrics would allow payers to reward providers for achieving positive patient outcomes, rather than simply paying for services.
5. Is quality measurement in behavioral health as advanced as it is in physical health?
No. Quality measurement in behavioral health is significantly less developed than in physical health.This disparity hinders progress in improving care and implementing effective value-based care models.
6. What are social determinants of health, and why are they important in assessing quality behavioral healthcare?
Social determinants of health (SDOH) are the non-medical factors that influence health outcomes – things like housing, food security, transportation, and social
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