Strategies for Measuring the Quality of Psychotherapy

Strategies for Measuring the Quality of Psychotherapy : A White Paper to Inform Measure Development and Implementation

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Description

People with depression, anxiety, post-traumatic stress disorder, and other mental disorders can benefit from evidence-based psychotherapy. However, the extent to which these therapies are available and implemented effectively is unclear as few performance measures of psychotherapy care exist. Of the psychotherapy measures identified none are endorsed by the National Quality Forum. Although Medicaid is the single largest payer of mental health services in the United States, a recent search of the U.S. Department of Health and Human Services (HHS), Centers for Medicare and Medicaid Services (CMS) Measures Inventory ("measures used by CMS in various quality, reporting and payment programs") identified no "psychotherapy" measures currently in use by CMS. Of the psychotherapy measures that do exist, the vast majority focus on access to care or quantifying the number of visits rather than on the content of care (e.g., if protocol for care was followed) or outcomes of care. The Affordable Care Act encourages health care delivery system reforms that use budgeted payment systems coupled with performance measures to both disincentivize inefficient use of health care resources while also ensuring accountability for providing access to quality care. There is an increased need for performance measures to monitor the delivery and outcomes of psychotherapies in this context. Such measures would inform quality improvement and allow stakeholders to assess whether the services purchased were delivered as intended and achieved desired outcomes. These measures would allow payers to reimburse for the actual delivery (or non-delivery) of evidence-based psychotherapy. To advance the development of such measures, the HHS Office of the Assistant Secretary for Planning and Evaluation in partnership with the HHS Substance Abuse and Mental Health Services Administration contracted with Mathematica Policy Research and the National Committee for Quality Assurance to examine the strengths and limitations of different measurement strategies that could be used to assess the delivery of psychotherapy for the purposes of quality improvement and accountability. In this paper, we describe how structure, process, and outcome measures could be used to monitor and improve the delivery of psychotherapy. Such measures could be used to inform health care delivery system reforms that are influencing coverage and payment policies and quality of care going forward. We review the strengths and limitations of each type of measure and the data sources that could be used to support them. We focus on measures assessing the effectiveness and outcomes of care rather than other domains, such as measures that assess the utilization or costs of services. Table ES-1 is a summary of the measurement options.show more

Product details

  • Paperback | 68 pages
  • 215.9 x 279.4 x 3.81mm | 226.8g
  • Createspace
  • United States
  • English
  • black & white illustrations
  • 1508521069
  • 9781508521068