Assesses the availability of services. Structure measures can provide critical information about the adequacy of the network of providers within a health system, health plan, ACO, or state in terms of their training and capacity to offer evidence-based psychotherapy. Such information is helpful for assessing gaps in accessibility of care, especially in rural or underserved areas.
Provide guidance on infrastructure development and best practices. By defining the infrastructure needed to provide evidence-based psychotherapy, structure measures could help clinics and organizations understand and implement new approaches to care. As described in a later chapter, these new approaches to care could include the use of repeated outcome assessments to report symptoms and functioning to guide care. These measures could also have the flexibility to address different types of psychotherapies that would be relevant to different populations or provider settings. Structure measures could build on existing approaches to fidelity training and supervision used in research and developed for specific psychotherapies. Similarly, structure measures could lay out expectations for data systems and protocols for collecting information on symptoms and functioning and how to adjust treatment when there is no improvement. Such an approach could offer flexibility to select tools that are relevant to different populations or conditions.
Support credentialing and payment. Structure measures could support or complement existing credentialing processes, thereby allowing purchasers and health plans to select clinics or provider organizations that are equipped to provide evidence-based psychotherapy services and outcomes monitoring. Alternatively, performance on structure measures could be used as the basis for differential payment and incorporated into new models, such as the behavioral health home.
Support consumer choice. Health plans or other entities could make information available to consumers about the capability of providers to allow them to select providers that have expertise in evidence-based psychotherapy, including treatments specific to their conditions. This information could be provided in health plan provider directories and also made available to other providers to facilitate referrals to care consistent with consumers' desired treatment.