Maryland looks to improve CCBHC quality and reporting measures

In an effort to further improve the implementation of Certified Community Behavioral Health Centers (CCBHCs), the Institute for Innovation and Implementation at the University of Maryland held a meeting Wednesday on improving CCBHC quality and reporting measures. 

CCBHCs provide comprehensive behavioral care by providing case management, crisis response, peer support, and other services. Maryland currently has 5 federally-funded CCBHCs that serve Anne Arundel, Baltimore, Baltimore City, Montgomery, and Prince George’s counties. On Wednesday the Institute brought CCBHC experts to share both national and state perspectives on expanding the model in Maryland. 

 

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Jeffrey Vanderploeg, PhD, President and CEO of the Child Health and Development Institute of Connecticut, outlined best practices when developing target outcomes in the CCBHC model. Using and disaggregating evidence-based data to look for health disparities, differences between payer groups, and administrative policies that lessen workforce burnout all play a role in effective outcomes, he said. 

“Invest in your evidence-based treatments,” Vanderploeg said. “It’s an opportunity for you to use CCBHCs certainly to do that work, but also how can you expand and disseminate evidence-based treatments across your entire state using the platform of CCBHC.”

Proper data can then be used to address high-level policies that translate to better outcomes, he continued, citing examples such as lower rates of mental illness, children presenting in emergency departments, balancing costs and provider reimbursement, and better workforce retention. 

Keri Virgo, MPM, Director of the Office of Children, Young Adults, and Families at the Tennessee Department of Mental Health and Substance Abuse Services, brought insights on how state departments can better utilize data to improve health outcomes and partner with CCBHCs. 

For example, his department has a specific office of research that assists with behavioral health program assessments. Tennessee’s federally-funded programs can also provide evaluation components. 

The department also makes available dashboards for various behavioral health services that providers can use to make sure they are on par with service delivery. It also partners with the Cornerstone Research Institute and Vanderbilt University Medical Center to collect data and fidelity monitoring, or the consistent delivery of health interventions. 

“It’s important to note that as we continue to move forward in the mental health crisis that we’re in currently we need to pay attention to two things in particular,” Virgo said. “One is that we need to be able to partner with anyone and everyone to give folks what they need. The second is services and supports that are well measured and show improvement need to be our standard of care as they produce results and discrete decrease disparities in care.”

Mandi Ryan, Vice President of Healthcare Integration at Centerstone, shared an on-the-ground perspective of how the mental health and substance use disorder health system is working to implement the CCBHC model in various states, including Indiana, Illinois, Florida, and Tennessee.

In Tennessee, Centerstone focused on transforming its case management-based behavioral health services into a health homes model, with its own unique payment structure. 

“The care coordination aspect of CCBHC covers all of those activities that you do in health homes,” Ryan said. “So we moved away from the payment model of how we had been paid before and we moved to a case rate. We moved to having outcome performance measures that we were expected to meet, and for those we could earn quality stars and efficiency stars and be eligible for additional Outcome Performance payments each year.”

Ryan also outlined specific types of metrics Centerstone used within the CCBHC model, leveraging the use of their electronic health records (EHR). These included 1) structural metrics, such as using an EHR to make sure patients are successfully for their visits, 2) process metrics, such as placing screening assessments and lab orders into an EHR to make them readily accessible for claims processing, and 3) outcome metrics that measure blood pressure, diabetes, and other patient health metrics.