The National Quality Forum (NQF) has partnered with a coalition of health plans and the national digital therapy enablement platform Headway to create a new assessment tool that standardizes how behavioral health clinicians measure the progress of care.

The behavioral health industry, across specialties, has struggled with a lack of a standardized data measurement set. The NQF is leading a new initiative to change this and lay the groundwork for value-based care arrangements while improving patient care without increasing clinician workload.

The initiative, dubbed Aligned Innovation, aims to create an omnibus tool to measure depression and anxiety symptoms and function and develop a patient-reported outcome performance measure (PROPM) that measures symptom changes over time.

Digital behavioral health company Headway is the initiative’s first launch partner and is piloting new patient-reported quality measures with the help of 100 of its providers.

“As clinicians in behavioral health, we understand that we can only help our patients to the degree that we understand what’s happening for them,” Dr. Jeff Gould, senior medical director and head of Headway’s clinical team, told Behavioral Health Business. “We’re trying to move from a symptom-focused assessment tool to one that, in one tool, can assess functional abilities as well.”

New York City-based Headway matches patients with mental health providers in their insurance network and supplies providers with a technology suite to reduce administrative burdens. The provider reached a valuation of $2.3 billion after a $100 million raise in July.

Aligned Innovation is a 24-month project with two main aims: creating an omnibus tool that will measure depression and anxiety symptoms and function, and developing a patient-reported outcome performance measure (PROPM) that measures symptom changes over time.

NQF is a not-for-profit multi-stakeholder organization that oversees and provides guidance on health care measurements.

The Aligned Innovation Coalition’s membership consists of payers including CareFirst, Elevance Health, Geisinger, Highmark Health, Kaiser Permanente and BlueCross BlueShield Association, among several others.

“Measures will become broadly adopted and used, not just by one payer saying that they want to use them because that goes back to the challenge of fragmentation, but when multiple payers in a market all align and say, ‘We’re going to all hold you, providers in our network, accountable for this measure, and we’re all going to use the same measure and do it in the same way,”’ Dana Gelb Safran, president and CEO of NQF, told BHB.

The coalition’s membership includes several payers belonging to the same market, making this push possible, Safran said. Depression and anxiety are both particularly high priorities for both public and private sector payers, creating strong potential for alignment across payers and purchasers to adopt Aligned Innovation’s measurement tools.

Payer relationships have been key to Headway’s expansion strategy. In December 2023, the company announced a national expansion through partnerships with over 50 commercial health plans. 

The company’s payer partners were also the impetus for Headway joining Aligned Innovation, according to Olivia Davis, chief commercial officer of Headway.

“We actually got calls from, in the same week, several of our health plan partners saying … ‘Hey, this is something we’d love to invest in,'” Davis told BHB. “[The] timing is excellent for us because we were spending a lot of time with our providers on how we could be both supporting them and also be measuring the efficacy of the care that they’re delivering.”

Headway’s participation in Aligned Innovation involves serving new surveys to patients and submitting that information to NQF. Headway providers participating in the program have already distributed a new set of surveys to 250 patients, Gould said, and over 1,000 individual assessments have been completed with data sent back to NQF.

Participating providers also meet with NQF monthly to provide input on usability and effectiveness.

Theoretically, Headway could make measurement-based care using Aligned Innovation’s measurement system a requirement for providers it partners with, Safran said.

“Headway is an exciting partner for us, not just because they’re so actively working with us in the measure development process, but [because] they could be very helpful in the scaled adoption and use of the measure as well,” Safran said. “As could other virtual or even app-based mental health care providers.”

Requiring providers to practice measurement-based care is not currently a consideration for Headway, Gould said, but the company does seek to provide diversity in its assessment library so that clinicians can use the tools they prefer.

While Aligned Innovation seeks to change the behavioral health industry’s system of measurements, it also aims to avoid increasing clinician labor, according to Safran. For every new measure the coalition adds, it must agree to retire two or more other measures.

Certain behavioral-health-specific challenges make the implementation of Aligned Innovation measurements more difficult. Generally speaking, incorporating assessments like the PHQ-9 depression assessment and the GAD-7 anxiety assessment requires technology adaptation, including implementing an electronic health record (EHR) and a shift in company culture to focus on improving scores.

The organization is also developing a system of measures for maternal health that will be easier to implement, Safran said.

The behavioral health measurement tool will be available in the third quarter of 2025. Safran said it was hard to predict when the measures will be broadly adopted, but implementation could begin immediately during Q3 2025 or anytime after.

The priority of developing an omnibus measurement tool is improved care for patients, Headway and NQF told BHB.

“My ultimate vision would be that it’s a tool that is easily adopted by a wide variety of clinicians and able to be applied for a wide variety of problems, issues and behavioral health struggles that our patients come to us with,” Gould said. “Right now there are some really useful applications for measurement-based care, and there are limits. … By expanding into new, more universal tools that can better someone’s life, I’m hopeful that we can apply this type of treatment measurement throughout the industry on a wider basis.”