What is the likely impact of pay-for-value on mental health treatment? What are the effects of these changes on the organizations serving consumers with mental health disorders? How do we assure quality mental health service delivery in a changing health and human service financing landscape?
Those three questions were the focus of today’s web briefing, Quality Mental Health Care In A Value-Based Environment: Keeping The Vision Beyond Mental Health Month, that I co-presented with Askesis’ Vice President of Technology and Business Development, Robert Teitt. The quality issue is critical. But health plan managers and clinical professionals alike agree that the measures of what is “quality” mental health are far from settled (see For All The Performance Measurement, Are We Really Measuring Performance? and A Few More Drops In The Performance Measurement Bucket).
Our team sees three drivers of the measurement of quality (and value) in the current environment. First, what consumers think matters more than ever before. Consumer expectations are changing and ushering the era of “consumer sovereignty” (see Consumer Sovereignty As Success Strategy and Another Look At Consumer Sovereignty). Consumers of all kinds of health services have come to expect “more” – not only “best practice” treatment but also personalization, convenience, and great experience.
Then, there is the “trickle down” effect of health plan ratings. With the majority of the U.S. population getting their health services through health plans, the health plan ratings are more important than ever. Consumers rely more than ever on ratings to select a health plan – and health plan managers are focused on the services and provider organizations that can improve those ratings. Whether the ratings are based on the “right” measures of quality is another story. (For more on the effect of The National Committee for Quality Assurance (NCQA) Healthcare Effectiveness Data and Information Set (HEDIS) and the Centers for Medicare & Medicaid Services (CMS) STARS rating systems, check out The Dominant Performance Standards Of Today – CMS Stars & NCQA HEDIS, Adherence, Coordination & Integration: What The New SMI HEDIS Measures Mean For The Field, and Are You Suffering From Measurement Fatigue?).
Finally, there is the new era of transparency brought to us by an ubiquitous internet. Whether curated like the CMS STARS site, which rates health plans, hospitals, nursing home, or more (to see for yourself, check out Hospital Compare), or the open source sites that crowdsource ratings like this one on Yelp – The Best 10 Counseling & Mental Health, the ratings are available for all to see – and that gets attention. This is a new context for the “quality” issue.
But beyond the issue of how the measurement of quality is changing, there are other factors to consider in forecasting what is “to come” in mental health treatment. So what are the proverbial “tea leaves” of the future treatment system? First there is the continued move of services to community-based settings. The use of “residential” levels of care as a health care intervention continue to decline as technology and flexible funding make more service delivery possible in consumers’ homes. But, we will see more consideration of “residence” (as in housing) as a factor in health care (see Is Housing Health Care? and Residential Care ‘Repackaged’).
Another factor is that technology is creating the era of “mental health care everywhere” with screening kiosks in grocery stores (see Crowdfunding Campaign Funds More Behavioral Health Screening Kiosks In Philadelphia), the proliferation of tech-enabled clinical services (see The Telehealth Market – Now, Soon & Future and Next Generation Service Delivery: The Future Of Telehealth Technology), mental health care management on mobile platforms (see HealthTap Collaborates With Facebook To Provide Free Text Access To Physicians and Primary Care Goes Virtual & On-Demand), and tech-enabled mental health in retail locations (see What To Make Of The Popular Press Romance With Tech-Delivered Therapy and Walgreens To Offer Behavioral Health Services Nationwide Through MDLIVE Collaboration). Whether tech-enabled services are viewed as “good” or “bad,” they are here to stay.
This very technology is remaking the traditional model of case management for supports for consumers with complex needs. The focus on a model that is primarily face-to-face services will likely morph into a hybrid model using tech-enabled platforms that allow consumer self-direction and leverage analytics to determine the type and frequency of care coordination supports. And, this technology will likely change the preferred model for primary care/behavioral health integration. The “one-stop shop” with co-located services will become, for some consumers, the one-stop experience – with disparate health care professionals collaborating in real time on a consumer’s care using virtual tools.
For more, you can listen to the entire webcast at Quality Mental Health Care In A Value-Based Environment: Keeping The Vision Beyond Mental Health Month. And, if you can’t join us in New Orleans next week for The 2016 OPEN MINDS Strategy & Innovation Institute, don’t miss our online coverage of the presentation by Kristofer L. Smith, M.D., MPP, Vice President & Medical Director, Northwell Health Solutions, “The Strategic Path To Health System Sustainability: Lessons From Northwell Health.”