Promoting measurement-based care and quality measure development: The APA mental and behavioral health registry initiative.

Abstract

Measurement-based care has important implications across multiple avenues in mental and behavioral health care, including clinical care, quality improvement, and accountability. Using measurement-based care to demonstrate that quality care is being provided within the context of cost-efficient care could strengthen the position of mental and behavioral health providers as critical members of the health care system. Yet when measurement-based care is used to assess performance of providers, and then that performance influences reimbursement, it must be done with great care and deliberation so as not to result in unintended consequences such as punishing providers. Given psychology’s expertise in measurement, the American Psychological Association (APA) and its members are uniquely suited to be leaders in promoting measurement-based care to assess quality and value. In this policy analysis paper, we examine the importance of measurement-based behavioral and mental health care across a variety of public service populations. We describe the increased federal regulatory focus on promoting quality and cost efficient care, the importance of defining and measuring quality care, and introduce an important resource being developed by APA to promote provider engagement in measurement-based care and effective participation in payment reform efforts in health care. We conclude with specific recommendations for how the field can move forward with using measurement-based care to assess accountability.

Measurement-based care and psychological assessment: Using measurement to enhance psychological treatment.

“…One of the strengths of this issue is the reflection provided on MBC implementation in various systems and in different populations. Wright and colleagues (2020) offer an excellent overview of the practical use of measurement-based care to both improve quality outcomes for mental health and increasing efficiency of service care delivery, beautifully housing this within the framework of the Quadruple Aim. Their article provides an overview of the development and application of the American Psychological Association’s Mental and Behavioral Health Registry, which aims to promote MBC across the country.…”

Peak-end bias in retrospective recall of depressive symptoms on the PHQ-9.

“…To capture more accurate reports of clinical symptoms, there have been significant efforts to institute measurement-based care (MBC) practices in behavioral health settings, with standardized clinical symptom assessments used to inform treatment decisions (e.g., Lewis et al, 2019). MBC has demonstrated improvement in clinical costs and outcomes, leading to large implementation efforts to expand MBC by psychologists (e.g., Wright et al, 2020), psychiatrists (e.g., Aboraya et al, 2018), and health care systems like the Veterans Health Administration (e.g., Resnick & Hoff, 2020).…”

Client-focused assessment and intervention: Tailoring the work to the client.

“…Interestingly, survey research generally demonstrates that therapists endorse positive attitudes toward routine client assessment with standardized measures; however, actual utilization rates (e.g., use of a ROM-feedback system) remain low Wright et al, 2020). For therapists, the disconnection between attitudes and behavior is likely explained, at least in part, by resource and logistical constraints.…”