Behavioral Health Quality & Data Building Stacey Palmer, LPCC Bridgette Baca, LMSW

Behavioral Health Metrics Learning Objectives Behavioral health metrics commonly used terms National Data Sets associated with quality treatment Implementing Behavioral Health Quality

Behavioral Health Metrics What are Behavioral Health Metrics Commonly used terms: Key Performance Indicators (KPI’s) - measurable value that demonstrates how effective a company is achieving key objectives. KPI’s are evaluated over a period of time and are compared against acceptable norms or past performance metrics Metrics - quantifiable measure that is used to track and assess the status of a specific process. A metric can be derived from one or more measures Measures - numbers or values that can be summed and/or averaged. Measures are unit specific.

Behavioral Health Metrics What are Behavioral Health Metrics Why are measures important? Both KPI’s and metrics rely on and are derived from measures Without identifying specific measures you do not have the capacity to understand outcomes for KPI’s and metrics - your ability to identify progress becomes challenging.

Behavioral Health Metrics Data Sets Healthcare Effectiveness Data and Information Set (HEDIS) CMS contracted with National Committee for Quality Assurance (NCQA) to develop a strategy to evaluate quality of care HEDIS includes more than 90 measures across 6 domains of care which include: Effectiveness of Care Access/Availability of Care Utilization and Risk Adjusted Utilization Health Plan Descriptive Information Measures Collected Using Electronic Clinical Data Systems

Behavioral Health Metrics Data Sets HEDIS is a comprehensive set of standardized performance measures designed to provide purchasers and consumers with the information they need for reliable comparison of health plan performance HEDIS performance data can identify opportunities for improvement, monitor success of quality improvement and provide a set of standards that allow comparison with other plans -Centers for Medicare and Medicaid Services (CMS)

Behavioral Health Metrics Data Sets Uniform Data System (UDS) UDS is a standardized data reporting system that provides consistent information about health centers, including: Patient Demographics Staffing and Utilization Services Provided Quality of Care Measures Health Outcomes and Disparities Financial Costs Patient Related Revenue -Bureau of Primary Health Care, HRSA

Behavioral Health Metrics Data collection Data can be obtained in a number of ways, which include: Claims data Medical Record Review/Retrieval Patient Survey

Behavioral Health Metrics Behavioral Health Measures Behavioral Health has multiple measures that include the following: Episodes of Care Appropriate Psychotropic Medication Management and Adherence Initiation and Engagement of Drug & Alcohol Abuse Treatment BH Screening Results (i.e. PH9 and CAGE) and Documented Follow up

Behavioral Health Metrics Behavioral Health Measures

Behavioral Health Metrics Behavioral Health Measures 2018 Core Set of Behavioral Health Measures

Behavioral Health Metrics Behavioral Health Measures 2019 HEDIS Measures

Behavioral Health Metrics Behavioral Health Measures 2019 HEDIS Measures

Behavioral Health Quality Making the shift How many of you provide quality behavioral health care? How do you know you are providing quality care? What do you use to measure quality behavioral health care?

Behavioral Health Quality Making the shift Where do you start? Start small - Plan, Do, Study, Act Research data sets, inquire about state initiatives, client access hours, customer satisfaction surveys. Determine what data is important/meaningful to you and your organization. Confirm how you can capture the data Create a simple pilot project to test your measure

Behavioral Health Quality Making the Shift How do you get staff adjusted to data? Talk about it! Data needs to be a part of the everyday conversation Quality data corresponds with quality care for patients

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