Clinicians are failing to make improvements in the quality of behavioral health care, particularly lagging in follow-up after hospitalizations for mental health, according to a report from the National Committee for Quality Assurance.
The annual “State of Health Care Quality” report found that quality scores declined for follow-up after hospitalization for mental health both at 7 days and at 30 days after discharge. Health plans reported to the NCQA that between 34% and 55% of patients received outpatient follow-up within 7 days, and 54%-73% received 30-day follow-up. Initiating and continuing treatment for alcohol and other drug dependence also dropped, with health plans reporting that between 34% and 40% of patients were started on treatment within 14 days of diagnosis in 2013.
Margaret O'Kane
Even in areas where there was statistically significant improvement, such as in follow-up care for children prescribed ADHD medication, less than half of patients were receiving the recommended care, according to the NCQA report.
“We know that people who have behavioral health issues are often very high users of medical care as well, and so there is both a quality argument to be made and a value argument to be made about appropriate treatment for behavioral health conditions,” said Margaret E. O’Kane, NCQA president.
Across 139 measures covering several health domains, the NCQA found a mixed picture of quality. The report, which is based on 2013 data, showed consistent and statistically significant improvement on 64 quality measures over the last 3-5 years. But 11 measures showed consistent declines in quality over the same time period, and another 64 measures had mixed results, showing no statistical trend.
“We can do better, and we know that as policymakers and payers become more strategic about their desire to drive a quality message, we actually can see the results of that,” Ms. O’Kane said during a webinar on the report’s findings.
The NCQA quality report card is based on voluntary reporting of HEDIS (Healthcare Effectiveness Data and Information Set) measures from 814 HMOs and 353 PPOs covering about 171 million individuals.
The NCQA will continue to focus on measuring behavioral health measures in the hopes of improving quality, Ms. O’Kane said. In next year’s report, the NCQA will publish results for three new behavioral health measures: the use of multiple concurrent antipsychotics in children and adolescents, metabolic monitoring for children and adolescents on antipsychotics, and the use of first-line psychosocial care for children and adolescents on antipsychotics.
mschneider@frontlinemedcom.com
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