Behavioral Health Care Industry Must Adopt Outcomes-Driven Systems That Produce Measurable Results, According to AMBHA Chairman and PBH Chief Clinical Officer
Posted on: Thursday, 9 December 2004, 09:00 CST
SANTA ANA, Calif., Dec. 9 /PRNewswire/ -- Behavioral health care services in the future must deliver measurable results, both in terms of clinical and economic outcomes of care, according to Edward Jones, Ph.D., chairman of the board of the American Managed Behavioral Healthcare Association and vice president and chief clinical officer of PacifiCare Behavioral Health (PBH).
Dr. Jones addressed mental health professionals Dec. 3 at the annual National Managed Behavioral Healthcare Forum in Dallas.
According to Dr. Jones, behavioral health care services today often do not include the use of outcome measures to identify undetected risks during psychotherapy, track patient change as therapy progresses, or report on treatment effectiveness. A consumer-focused marketplace, combined with increasing health care costs, demands that managed behavioral health care organizations develop results-driven clinical strategies that demonstrate return on investment and value to payers and members.
PBH introduced such a strategy in 1999 when it launched its pioneering ALERT(R) outcomes management system that measures and reports on the quality of care its members receive. To date, more than 140,000 PBH members receiving outpatient treatment have participated in the ALERT system.
ALERT uses 30-item patient self-report questionnaires administered at multiple points during psychotherapy. It compares patient self-assessment with provider assessment, identifies risks that may have been undetected by therapists, and tracks change during treatment for each patient. The system also utilizes clinical algorithms to transform the raw patient data into information that clinicians and PBH care managers can use to determine the appropriate intensity of care.
"ALERT is unique because it collects data in the clinician's office while care is being delivered, and then immediately provides feedback on clinical issues to help guide new treatment interventions that can make a significant difference in clinical outcome," stated Dr. Jones. "ALERT data have helped clinicians become more aware of suicide and substance abuse risks. ALERT data even document the ability of therapy to improve workplace productivity."
With intervention, ALERT has improved therapist detection of suicide risk by 35 percent and substance abuse by 17 percent, according to PBH. In addition, ALERT data validate the effectiveness of behavioral health treatment, demonstrating that two-thirds of individuals who entered treatment functionally impaired are productive again after nine weeks of therapy.
"An added bonus of the ALERT system is that it helps to identify the clinicians who consistently produce the best outcomes," said Dr. Jones. "Our research has shown that highly effective therapists achieve clinical outcomes that are many times better than those achieved by the least effective clinicians. When members receive care from top-performing therapists, they tend to improve more quickly, ultimately giving purchasers more value for their benefit dollar."
The Institute for International Research hosted its 6th Annual National Managed Behavioral Healthcare Forum titled "Innovative Clinical and Operational Programs for the Public and Private Sectors" Dec. 1 - 3, 2004 in Dallas, at the Westin City Center.
About PacifiCare Behavioral Health
PacifiCare Behavioral Health, Inc. provides mental health, chemical dependency and employee assistance services to covered members and maintains a national network of behavioral healthcare practitioners. All PacifiCare Behavioral Health service centers hold three-year, Full Accreditation from the National Committee for Quality Assurance (NCQA), as well as URAC Health Utilization Management Accreditation. PacifiCare Behavioral Health is a wholly owned subsidiary of PacifiCare Health Systems , with clients including health plans, union trust funds, employers, school districts and public sector agencies. More information on PacifiCare Behavioral Health can be obtained at http://www.pbhi.com/.
About PacifiCare Health Systems
PacifiCare Health Systems is one of the nation's largest consumer health organizations with more than 3 million health plan members and approximately 10 million specialty plan members nationwide. PacifiCare offers individuals, employers and Medicare beneficiaries a variety of consumer-driven health care and life insurance products. Currently, more than 99 percent of PacifiCare's commercial health plan members are enrolled in plans that have received Excellent Accreditation by the National Committee for Quality Assurance (NCQA). PacifiCare's specialty operations include behavioral health, dental and vision, and complete pharmacy and medical management through its wholly owned subsidiary, Prescription Solutions. More information on PacifiCare Health Systems is available at http://www.pacificare.com/.
CONTACT:
Dagmar King Dan Miller
PacifiCare Behavioral Health PacifiCare Health Systems
(714) 445-0453 (714) 226-3726
dagmar.king@phs.com dan.miller@phs.com
PacifiCare Behavioral Health
CONTACT: Dagmar King of PacifiCare Behavioral Health, +1-714-445-0453,dagmar.king@phs.com; or Dan Miller of PacifiCare Health Systems,+1-714-226-3726, dan.miller@phs.com
Web site: http://www.pacificare.com/
Web site: http://www.pbhi.com/
Source: PRNewswire
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