Harold Alan Pincus, Sarah Hudson Scholle, Brigitta Spaeth-Rublee, Kimberly A. Hepner, and Jonathan Brown
H. A. Pincus, S. H. Scholle, B. Spaeth-Rublee et al., “Quality Measures for Mental Health and Substance Use: Gaps, Opportunities, and Challenges,” Health Affairs, June 2016 35(6):1000–8.
There has been little progress in the decade since the Institute of Medicine called for more rigorous assessment of the quality and safety of treatment for mental illness and substance use disorders. But incentives designed to improve behavioral health care in the Affordable Care Act, the Mental Health Parity and Addiction Equity Act, and other legislation are creating momentum for better performance assessment measures. In a Health Affairs study, Commonwealth Fund–supported researchers provide an overview of current measures of behavioral health, identify priorities for measure development, and outline the most significant challenges.
There are 510 measures related to behavioral health, but only about 5 percent are used in quality-reporting programs and only 10 percent have been endorsed by the National Quality Forum. Quality reporting so far appears to have had limited effect on behavioral health: based on Healthcare Effectiveness Data and Information Set (HEDIS) reports from commercial health plans, patients receive recommended behavioral health care less than half the time, with slow improvement in recent years.
In terms of measure development, the authors identify five priorities:
To promote measurement strategies and improve behavioral health care, the authors call for greater workforce investment and stronger coordination among leaders in the field. And they argue that a stronger evidence base, drawing from more robust data sources, is needed to support performance assessments.