Developing and Testing Quality Measures to Improve the Quality of Behavioral Health Services

2011-2015
Prepared for
U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation
Office of Disability, Aging, and Long-Term Care Policy
U.S. Department of Health and Human Services, Substance Abuse and Mental Health Services Administration
U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services

Improving the quality of behavioral health services is one of the many goals of health care reform. To achieve this, the Substance Abuse and Mental Health Services Administration  has developed a National Behavioral Health Quality Framework to establish quality improvement priorities. These priorities include promoting effective prevention, treatment, and recovery; ensuring that behavioral health care is person and family centered; encouraging care coordination; assisting communities to use best practices that enable healthy living; and ensuring that behavioral health care is safe and affordable.

Mathematica is working with the National Committee for Quality Assurance (NCQA) to develop and test measures that can be used to monitor progress toward reaching the goals of the National Behavioral Health Quality Framework. Several types of measures are under development: 

  • Measures that health plans and state agencies can use to monitor whether individuals with serious mental illnesses and alcohol or drug use disorders receive preventive health care and monitoring of chronic conditions 
  • Measures to monitor care coordination
  • Measures that assess screening and follow-up care for the Centers for Medicare & Medicaid Services Inpatient Psychiatric Facilities Quality Reporting (IPFQR) program

These measures use data from Medicare and Medicaid claims as well as electronic and paper medical records. Mathematica and NCQA are testing these measures to assess their scientific acceptability, feasibility, usability, and importance and will then submit the most promising measures to the National Quality Forum for endorsement.