Standardized metrics in behavioral health care are key to delivering quality treatments and better outcomes for patients. Metrics provide a common language for clinicians, enabling them to align on treatment goals and measure progress more effectively.
To better align on what “quality care” encompasses and reimburse providers for delivering improved health outcomes, Evernorth launched a measurement-based care approach last year for its behavioral health network.
The initial pilot launched with 44,000 network clinicians and currently stands at more than 53,000 providers. The providers include behavioral health therapists who can help with a variety of mental health conditions, including anxiety, depression, sleep disorders, substance use disorders, and more. Evernorth identified key metrics for the program to ensure that customers have quick access to high-quality care, including measures of how long it takes a patient to get an appointment and how well the patient and provider formed a therapeutic relationship.
Just a year in, the data is demonstrating that people treated by participating clinicians are receiving quick access to high-quality care.
“This alignment on metrics fosters improved collaboration among providers and ensures that patients receive evidence-based care tailored to their specific needs,” said Eva Borden, president of behavioral health at Evernorth. “Standardized metrics help identify gaps in care and opportunities for improvement, driving advancements that can reduce costs and administrative burdens. A more standardized approach to measurement-based care ensures that all patients have access to high-quality care that is both timely and effective.”
Time to care and therapeutic alliance
Delaying care for mental health conditions like depression and anxiety can make symptoms worse, and opportunities for early intervention may be missed. As 56% of psychologists report they do not have openings for new patients, the ability to provide timely access to care is more meaningful than ever. As part of the measurement-based care approach, we are seeing that more than 96% of those providers have appointment availability in 3 days or less.
Research from Evernorth has found that behavioral health utilization is associated with medical and pharmacy savings of up to $2,565 in the 15 months post diagnosis. The greatest savings were observed for patients who utilized at least three sessions with a therapist – referred to as therapeutic alliance. Evernorth is proud to share that today, 80% of patients seeing a provider participating in measurement-based care have achieved therapeutic alliance.
Dr. Doug Nemecek, chief medical executive for behavioral health quality, integration, and clinical operations at Evernorth, said that measurement-based care represents a true partnership between providers and payers. “We are working together to help move the needle to enhance our customers’ behavioral health,” he said. “Providers want to be focused on patient care, not on paperwork. We plan to incorporate measurement in ways that minimize administrative burdens and maximize the benefits for providers and patients. By embedding shared metrics in the patient journey, payers and providers will develop insights into access and outcomes that will benefit everyone.”
Looking ahead
Evernorth’s commitment to measurement-based care initiatives remains strong. Evernorth will continue to collaborate with participating providers to further study the unique factors that drive clinical excellence for patients with specific conditions. Our focus will be to identify metrics that reflect clinical and functional improvement for the member. Further, we will better understand the connection between high quality care and affordability.
“We already know that measurement-based care is a meaningful opportunity to emphasize patient outcomes as a therapeutic goal,” Borden said. “Now we are going to demonstrate that collaboration among payers, providers, and patients can help to better define outcomes and align patients and providers who are likely to achieve those outcomes together.”
