Measuring Success: Behavioral Health Outcome Measurements and the Affordable Care Act
Sustainability and Structure
There are many factors contributing to the changes we see occurring within mental and behavioral health care: policy, resources, emerging technology and modalities, not to mention the day to day needs of both staff and clients. Adroitly providing service within this atmosphere of change is a central challenge for any practice.
To do so with stability – and sustainability – recognizes the utility of having a measurement strategy that is easy to use, reliable, and relevant. Emerging Behavioral Health Outcome Management (BHOM) technology offers just this type of strategy for programs to confidently step forward and meet evolving client as well as organizational needs. And finding a BHOM that works for your practice lends your organization authority by demonstrating in measureable terms your successes and ability to make relevant changes.
Beyond Organizational Aims
With recent changes in the healthcare system, the behavioral health field is increasingly shifting away from productivity measures and towards outcome measures. The motivation comes – in part – from recent changes in the Affordable Care Act (ACA). With the ACA, mental health centers will have more opportunities to serve new, previously uninsured clients. And with ACA, accountability is no longer “optional” (if it ever really was) with increasing demands that practices demonstrate the medical necessity of their services.
It’s a paradigm shift to be sure, and in the mayhem of this overhaul, practices struggle to ensure that potentially positive outcomes don’t get lost in the headache of paperwork, shifting ideals and operations, and the increase in case loads. But as more and more tools for improved outcomes assessment and management continue to emerge – with an evolving focus on helping leaders establish accountability in their practice – this period of change has a ‘light at the end of the tunnel’ feel to it.
ACA regulations can be tedious and even seem a bit oppressive. But I believe that this movement in mental and behavioral healthcare has the potential to be just the opposite. For one, it focuses on the client and their perception of the value of their treatment. This invites the voice of the client into the conversation about the worth and effects of treatment (a privilege heretofore belonging almost exclusively to payers and providers). Also, by remaining accountable to ACA stipulations, practitioners are more than ever intentionally and intently trained on the changes in the lives of their clients – for better or for worse. This can have an empowering effect by forcing the question, “Is this really working?” and liberates practitioners to exercise innovative thinking.
That’s not to say that behavioral health professionals haven’t long been familiar with diagnostic, assessment, and outcomes-management. But the need to track patients’ progress with them along the way and to adapt accordingly (and quickly) is – to many – a new aspect to consider. Providers are coming to recognize that they need to develop clear ways to collect and organize data that demonstrates that their methods are, indeed, resulting in measurable improvements in the lives of their clients. And with more medical practices looking to incorporate mental health services, providers are looking to others, curious about how certain outcomes might trend over time. A consistent outcomes management tool – in time – will make that information available.
It’s da BHOM!
As care organizations seek to incorporate BHOM into their practice, they want to know – really – how this may impact relevant stakeholders, such as providers, payers, organizations, and the clients themselves. While we can’t say exactly, yet – as their widespread use is still relatively new to the scene – here are some thoughts about the projected effects:
Foremost in a provider’s skillset are intuition, experience, and education. A skillfully designed BHOM aids the provider by offering intelligent and coherent collection of data that can then help guide and inform the treatment of each individual patient…without minimizing their skills, talents, and abilities as caregivers.
Payers also wish to see improved outcomes with BHOM tracking. These improvements – from a financial standpoint – offer justifiable reasons to reduce (or extend) the need for future services for an individual client, potentially reducing long term costs.
Organizations that use performance management metrics are also set up to more accurately determine progress. This can then be applied towards reshaping aims and objectives as they move in the direction of the organizational mission.
And perhaps the most important stakeholders are the clients themselves. An informed client – attuned to BHOM navigation – shares the benefits of this tracking process by being afforded the opportunity to participate in monitoring their own challenges and successes, empowering them to become more engaged in their own care.
The Future Will be Streamed
With so many big changes going on within healthcare, we are seeing one definite emerging trend: That the future is tech-enabled and value-based. Some health plans are already requiring the integration of BHOM into routine care and treatment planning. A well-designed BHOM system provides the feedback and guidance to keep up with the evidence-based demands of the ACA.
And while it may be a tiresome period of turnover, that ‘light at the end of the tunnel’ is the potential growth of the entire field of mental and behavioral healthcare.
Formal assessments were always intended to assist providers in devising individualized treatment plans with increasingly meticulous attention. ACA’s push into new frontiers of required parameters of outcomes management has led to a new territory of pro-active engagement as caregivers in assisting the people they serve.
These programs aren’t designed to supplant traditional mental health care. If anything, they stand the potential to support caregivers in reaching a lot of people who aren’t yet getting the help they need. Their design is to track treatment progress, session-by-session, and to report the data. Their utility lies in the clients and caregivers taking the provided feedback about the course of treatment and adjusting appropriately.
The aim of any measurement strategy is to enhance effectiveness in addressing the challenges of the people a program serves. Program success – in many ways – starts with measurement. But the real value comes when we manage what we measure. Effective measurement strategies help providers achieve their ever-evolving benchmarks of patient and programmatic success.
At everythingEHR we take the changing field of mental health treatment very seriously. We also understand that as a behavioral healthcare provider you need a system that takes you beyond measurement and embraces accountability. Let us help you find the BHOM that’s right for your organization.
Please feel free to reach out by emailing Kristin@everythingehr.com.