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Development and Testing of Behavioral Health Quality Measures for Health Plans: Final Report

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Many people with behavioral health disorders receive suboptimal care and suffer poor health outcomes, including premature death. States, health plans, providers, and other stakeholders need a strong set of measures targeting this population to improve the quality of their care. In this project, we developed and tested measures reported by health plans that focus on screening and monitoring of care for comorbid conditions among people with serious mental illnesses (SMI) and/or alcohol or other drug dependence (AOD). For the SMI population, these measures focused on assessing comprehensive diabetes care; controlling high blood pressure; and screening for body mass index (BMI), high blood pressure, tobacco use, and unhealthy alcohol use. For the AOD population, the measures focused on screening for high blood pressure, depression, and tobacco use. We also developed a measure for health plan reporting to assess the extent to which people discharged from the emergency department (ED) for mental disorders or AOD receive timely follow-up care. In March 2015, the National Quality Forum (NQF) endorsed 11 measures from this project. [98 PDF pages]