Only 25% of Behavioral Health Leaders Feel Prepared for Value-Based Care, Citing Concerns Over Data Collection

A new survey shows a hesitance by behavioral health executives to use real-time data gathering to guide care and help their organizations implement value-based care arrangements.

The survey — released by Portland-based Owl and trade organization MHCA — measures the attitudes and priorities of nearly 100 community mental health center executives surveyed in October 2021 when it comes to measurement-based care, value-based care (VBC) arrangements and other aspects of operating a mental health clinic influenced by data collection. 

Owl provides a cloud-based, measurement-based care (MBC) system for behavioral health providers and was founded in 2013. MHCA is a nonprofit association of behavioral health executives focused on innovation and C-suite executive development.

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The survey suggests there is widespread knowledge about MBC but little adoption of the practice: 83% of respondents said their organization had knowledge of the system but 16% said they consistently used it.

The survey report defines MBC as “the practice of using standardized measurements to assess behavioral health patients to inform treatment decisions.”

About 54% of respondents said their organization uses MBC inconsistently and 29% weren’t using MBC at all.

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In contrast, 66% of respondents said they currently gathered patient-reported outcomes measures (PROMs) to support clinical decision making while 34% did not. Among those that do gather PROMs, 66% reported doing so through their electronic health record while 17% used paper or some other method of gathering data, respectively.

The survey states that PROMs are any report from patients about their status without interpretation by a clinician or anyone else, citing a definition provided by the National Quality Forum.

“From paper forms, to the EHR, to inconsistent methods, the survey suggests gathering data to support clinical decision-making is a pain point for behavioral health executives,” the survey report states. “In fact, 34% aren’t yet gathering patient-reported outcomes and 28% aren’t gathering or are unsure if they are gathering social determinants of health information.”

The survey also demonstrates a gap between key organizational priorities and capabilities in terms of data collection and use.

About 49% of respondents said that measuring clinical outcomes at the individual level was a high or medium priority, while 62% rated their organization’s capability of doing so as medium or low with 43% reporting medium capability.

For measuring clinical outcomes at the population level, 41% said doing so was a high or medium priority while 68% rated their organization’s ability to do so as either medium or low with 40% reporting low capability.

Data collection and analysis are vital to implementing and succeeding in value-based care arrangements where health care providers receive payment for services based on some assessment of value.

In a webinar last month, a behavioral health executive with Owl client Chicago-based Amita Health said: “If you can’t quantify your clinical programs and the effectiveness of those programs, it’s going to be very hard to enter into a value-based care world…”

The survey also takes a pulse of executives’ feelings about value-based care — which were lukewarm at best.

About 24% of respondents said they felt a little or “not at all” prepared for value-based care arrangements with another 24% saying they assessed their preparation as “a lot” or “a great deal.”

The remaining 52% said they felt moderately prepared for value-based care with many free-form responses to a question regarding concerns about VBC centering around data collection and proving treatment effectiveness.

“One major barrier to improving access to behavioral health services is related to payment,” the report states. “Research supports shifting to value-based reimbursement to increase payment for providers who can demonstrate improved population health and cost efficiencies.”

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