BEHAVIORAL HEALTH

Overview

Improving the quality of behavioral health care has been a priority for NCQA since the early days of HEDIS, but targeted efforts have certainly accelerated since the launch of an accreditation program for managed behavioral healthcare organizations. As we remarked in the first edition of QUALITY PROFILES, behavioral health conditions have a tremendous impact not only on those affected and their families, but also on their productivity as employees. Yet our health care system faces enormous challenges in affecting meaningful improvements in this vital area.

First, there is widespread recognition of how different behavioral health care is from the rest of health care. We deploy different professionals, access different facilities, and even devise different benefit designs to administer behavioral health services. But what may be less appreciated is how the differences between behavioral health care and medical care complicate our efforts to coordinate and improve care across the spectrum.

Then, there are the issues of boundary definition, which are somehow more complex in the context of behavioral health. When, precisely, does acute treatment for depression end and maintenance treatment begin? Who manages the transition between inpatient and outpatient care, and with what tools? What is actually covered under the employer's benefit package?

These complicated questions are at the heart of both of the efforts described in the section that follows. But despite the differences between medical and behavioral health care demonstrated in these profiles, we can also observe at least one major similarity: The human touch is paramount for these QI efforts to succeed, and teamwork remains the only way to improve the functioning of massive systems of health care delivery.

Given the emphasis NCQA and others continue to place on behavioral health care, there is good reason to believe that we shall see continued enhancement in these areas in the coming years.