Friday, September 2, 2016

Review Finds Measurement-Based Care Improves Patient Outcomes

Measurement-based mental health care significantly improves outcomes, provided that symptom severity data are collected frequently and the results are provided to the clinician shortly before or during the clinical encounter, according to a literature review published Thursday in Psychiatric Services in Advance.

Moreover, the authors of the review said measurement-based care (MBC)—the systematic administration of symptom rating scales and use of the results to drive clinical decision making at the level of the individual patient—can be used to enhance professional development at the provider level, facilitate practice-level quality improvement, demonstrate the value of mental health services to purchasers and payers, and positively influence reimbursement policy. 

John Fortney, Ph.D., of the University of Washington and colleagues reviewed 51 articles on the use of MBC. They found that randomized, controlled trials with frequent and timely feedback of patient-reported symptoms to the provider during the clinical encounter significantly improved outcomes or showed trends toward significance; these findings were robust and consistent across patient groups, providers, and settings.

While Fortney told Psychiatric News that measurement-based care has been widely adopted by large integrated systems of care, other settings have been slower to adopt this approach. “Given the rapid changes being made by accreditation agencies and payers, those health care organizations that have not yet started to develop systems to support measurement-based care should begin identifying tools and protocols that meet their patients’ needs before such systems are imposed from outside their organizations,” he advised.

“The time is long overdue for the field of mental health to embrace MBC and live up to the medical testing and treat-to-target principles applied by other medical specialties,” the study authors wrote. “The cost of routinely administering symptom severity scales is minimal, yet the benefits of MBC accrue to all the stakeholders involved, including patients, providers, purchasers, and payers.” 

Measurement-based care is at the heart of the collaborative care model and advances the ability of clinicians to provide robust treatment for patients, said Lori Raney, chair of the APA Work Group on Integrated Care. Measurement-based care is “absolutely necessary for reporting outcomes to payers in the changing health care environment where value-based purchasing is the wave of the future,” she told Psychiatric News

For related information, see the Psychiatric News article “Collaborative Care Model Prepares Psychiatrists for Value-Based Care” and series “Changing Practice/Changing Payment” on the APA website.

(Image: iStock/Christopher Futcher)


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