PCMH Practices Address Behavioral Health

December 29, 2014 · NCQA

Kudos to NCQA-Recognized PCMH practices that continue their commitment to behavioral and mental health integration, and to those that earned extra scores, under 2014 requirements, for successfully integrating these services into their medical home. You are tackling one of health care’s greatest needs—managing care for people with serious mental illness (SMI).

NCQA’s State of Health Care Quality 2014 Report, which summarizes health plans’ quality results for 2013, told us that behavioral healthcare needs to improve, especially where mental illness and addiction treatment are concerned. NCQA’s President, Margaret O’Kane, agreed that it’s time to be bullish on behavioral health.

NCQA’s PCMH 2014 standards increase the focus on the value of integrating behavioral and mental healthcare into the PCMH. Practices are expected to support inclusion of behavioral health specialists through a formalized referral process.

Why does behavioral health matter?

Patients with comorbid conditions experience worse general medical outcomes. Care is fragmented and people with SMI are at a higher medical risk because of their medications.

NCQA-Recognized practices are leading by example in integrating care. The 2014 PCMH standards encourage practices to collaborate with other providers to manage patient care effectively.

Behavioral Health Quality Measurement Is Growing

Quality measurement in behavioral healthcare lags behind that of other chronic diseases, but NCQA is taking measurement to a new level with the addition of HEDIS measures that integrate physical and behavioral health.