Quality Measures Needed to Enhance Integrated Behavioral Health Care


A recent Journal of the American Medical Association Viewpoint article argues that developing quality measures for assessing and rewarding high quality integrated behavioral health care could promote widespread adoption of an integrated care model. Patients with behavioral health issues, such as serious mental illness and substance abuse, use more medical resources than other patients, particularly when these patients have comorbid medical conditions. Effective models of care exist that integrate physical and behavioral health services and have demonstrated improvements in patient outcomes and cost reduction. One model discussed in the article is collaborative care model, which has demonstrated cost savings in low-income, high-risk patient populations compared to traditional models. Despite cost-saving and patient outcome benefits associated with integration, these models have yet to be implemented on a large scale. One barrier to widespread implementation is the lack of systematic incentives, payment, and improvement strategies designed to reinforce best practices and outcomes for integrated care patients – key to this process is the development of valid quality measures. The article’s authors, Matthew L. Goldman, MD, MS, Brigitta Spaeth-Rublee, MA, and Harold Alan Pincus, MD, from Columbia University Medical Center, Department of Psychiatry, build the case that “developing and validating a set of robust quality measures that targets this high-cost/high-need patient population and is tied to new payment mechanisms can play a powerful role to encourage more cost-effective care.” Current quality measures tend to be rather limited in scope and do not address behavioral and physical health integration. The authors conclude that best practice and outcomes measures for integrated care “can increase accountability across health care settings, diminish disincentives to serve and treat […] complex patients, broaden dissemination of research-proven models that improve patient outcomes and enhance the efficiency of the health care system as a whole.”

For additional information on collaborative care models, view this Health Home Information Resource Center brief(PDF - 260 KB).