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

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

3. 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.

4. 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.

5. 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

6. 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)

7. 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

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

9. 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

10. Behavioral Health Metrics
Behavioral Health Measures

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

12. Behavioral Health Metrics
Behavioral Health Measures
2019 HEDIS Measures

13. Behavioral Health Metrics
Behavioral Health Measures
2019 HEDIS Measures

14. 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?

15. 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

16. 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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