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    High Performance

Measuring Quality

The growing use of quality performance indicators has now become an increasingly important part of payment and cost control incentives for both health plans and providers. Measuring and reporting on a treatment program’s performance measures helps to ensure an organization’s health care system is delivering effective, safe, efficient, patient-centered, equitable, and timely care. Unfortunately many behavioral health providers are still far behind in developing effective internal monitoring for quality Improvement and in developing performance measurement criteria. Persistent provider problems identified include poor patient retention due to early unplanned discharges, low treatment completion rates, high re-admission rates, as well as many other problems.

1.  What are Quality Measures?

Clinical quality measures, or CQMs – are tools that continuously measure and track the quality of health care services provided by professionals, facilities within the health care system. These measures use data associated with providers’ ability to deliver high-quality care or relate to long term goals for quality health care. CQMs measure many aspects of patient care including:

  • Cost of services
  • Tracking Health Outcomes
  • clinical processes
  • patient safety
  • efficient use of health care resources
  • care coordination
  • patient treatment services
  • population and public health
  • adherence to clinical guidelines

Measuring and reporting Clinical Quality Measures (CQM’s) helps to ensure an organizations health care system is delivering effective, safe, efficient, patient-centered, equitable, and timely careThe growing use of quality performance indicators has now become an increasingly important part of payment and cost control incentives for both health plans and providers. Some medical facilities are often reporting as many as 80 different quality indicators with most of this information directly available to consumers.

2. Impact on Behavioral Health Providers

Unfortunately many behavioral health providers are still far behind in developing effective internal monitoring for quality Improvement and in developing performance measurement criteria. Persistent problems identified include poor patient retention due to early unplanned discharges, low treatment completion rates, high re-admission rates, as well as many other problems.

Most treatment program improvements can only be corrected through the adoption of a comprehensive Quality Improvement System. These Quality Improvement processes will work effectively only when behavioral health providers adopt a new mindset regarding their need to measure service performance outcomes.  Failures to upgrade legacy delivery systems will likely doom service provider unwilling or incapable of meeting the demands of this new, more competitive environment. As provider performance reports become readily available on the internet, only those programs conducting ongoing, comprehensive quality monitoring will likely survive this revolution in healthcare services.