Starting in 2017, the Joint Commission will require the 2300 behavioral healthcare organizations it accredits to initiate standardized measurement of interventions designed to improve patients' mental health outcomes.
"We're going to put in place a measurement-based care requirement," said Margaret VanAmringe, the Joint Commission's executive vice president for public policy and government relations, at a meeting sponsored by the Kennedy Forum and the Satcher Health Leadership Institute's Kennedy Center for Mental Health Policy and Research.
Attendees from government agencies, patient and mental health advocacy groups, philanthropic organizations, and academic institutions applauded the announcement.
Systematically tracking and reporting outcomes could help build an evidence base of best interventions and practices. In turn, the data could be used to reduce coverage exclusions, which are still common despite laws that require benefit parity for medical and mental health services, such as the Mental Health Parity and Addiction Equity Act of 2008.
According to the State of Parity report released at the February 26 meeting by the Kennedy Forum, founded by former congressman Patrick Kennedy in 2013 and the Scattergood Foundation, "insurers still circumvent the [Parity] law's requirements."
Samuel Nussbaum, MD, executive vice president and chief medical officer for Anthem, Inc, said that insurers are often stymied when trying to apply both the letter and the spirit of parity, in part because of a lack of evidence.
"How do we determine what works?" Dr Nussbaum asked.
The Joint Commission hopes to help answer that question with its new requirement, VanAmringe told Medscape Medical News. The current standard for the 2300 behavioral healthcare organizations it accredits requires outcomes assessments, but there is no requirement to use standardized measurement tools or to aggregate patient data, she added.
The new policy will require a standardized method of measurement that is sensitive enough to show that an intervention improved a patient's outcome. Organizations will also be required to assess outcomes on a population-wide basis and to use the information for continuous quality improvement, VanAmringe said.
That kind of data collection can "make your organization more valuable" to insurers, she said, "because you show that you are improving outcomes." The data can also be used to show that mental health care services work, she said. "Too often, people don't think that they are that effective," said VanAmringe.
A Joint Commission committee will review the proposed requirement in March. The requirement will then be made available for comment by accredited organizations, and it will be reviewed by the Joint Commission's board. It is hoped that the new standard will be announced in July, VanAmringe told Medscape Medical News.
Use of the new standard would not be required until January 2017 — about the time that the Centers for Medicare and Medicaid Services will start payment for its collaborative care model, which was made final in the 2016 Medicare fee schedule rule.
The model, developed at the University of Washington, creates a team involving a primary care physician, a care manager, and a psychiatric consultant.
It is still not clear what that model will look like or how physicians will be reimbursed. The CMS will "propose the details of that methodology" this year, said Patrick Conway, MD, the agency's acting principal deputy administrator, at the meeting.
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Cite this: Standardized Evaluation of Mental Health Treatment on the Way - Medscape - Feb 25, 2016.
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