title: The Current State of Behavioral Health Quality Measures: Where Are the Gaps?
abstract: OBJECTIVE
  This review examined the extent to which existing behavioral health quality measures address the priority areas of the National Behavioral Health Quality Framework (NBHQF) as well as the extent to which the measures have received National Quality Forum endorsement and are used in major reporting programs.
  
  
  METHODS
  This review identified behavioral health quality measures in widely used measure inventories, including the National Quality Measures Clearinghouse, National Quality Forum, and the Center for Quality Assessment in Mental Health. Additional measures were identified through outreach to federal agencies. Measures were categorized by type, condition, target population, data source, reporting unit, endorsement status, and use in reporting programs.
  
  
  RESULTS
  The review identified 510 measures. Nearly one-third of these measures address broad mental health or substance use conditions rather than a specific condition or diagnosis. Seventy-two percent are process measures. The most common data source for measures is administrative claims, and very few measures rely on electronic health records or surveys. Fifty-three (10%) measures have received National Quality Forum (NQF) endorsement, and 28 (5%) unique measures are used in major quality reporting programs. Several subdomains of the NBHQF, such as treatment intensification, financial barriers to care, and continuity of care, lack measures that are NQF endorsed.
  
  
  CONCLUSIONS
  Despite the wide array of behavioral health quality measures, relatively few have received endorsement or are used in reporting programs. Future efforts should seek to fill gaps in measurement and to identify the most salient and strongest measures in each priority area.
authors.affiliation: Mr. Patel, Ms. Lewis, Dr. Liu, and Dr. Scholle are with the National Committee for Quality Assurance, Washington, D.C. Dr. Brown and Ms. Croake are with Mathematica Policy Research, Washington, D.C. Dr. Patton is with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Ms. Potter is with the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, D.C. Send correspondence to Dr. Scholle (e-mail: scholle@ncqa.org ).
authors.forename: Milesh M
authors.initials: MM
authors.lastname: Patel
authors.affiliation: Mr. Patel, Ms. Lewis, Dr. Liu, and Dr. Scholle are with the National Committee for Quality Assurance, Washington, D.C. Dr. Brown and Ms. Croake are with Mathematica Policy Research, Washington, D.C. Dr. Patton is with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Ms. Potter is with the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, D.C. Send correspondence to Dr. Scholle (e-mail: scholle@ncqa.org ).
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Brown
authors.affiliation: Mr. Patel, Ms. Lewis, Dr. Liu, and Dr. Scholle are with the National Committee for Quality Assurance, Washington, D.C. Dr. Brown and Ms. Croake are with Mathematica Policy Research, Washington, D.C. Dr. Patton is with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Ms. Potter is with the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, D.C. Send correspondence to Dr. Scholle (e-mail: scholle@ncqa.org ).
authors.forename: Sarah
authors.initials: S
authors.lastname: Croake
authors.affiliation: Mr. Patel, Ms. Lewis, Dr. Liu, and Dr. Scholle are with the National Committee for Quality Assurance, Washington, D.C. Dr. Brown and Ms. Croake are with Mathematica Policy Research, Washington, D.C. Dr. Patton is with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Ms. Potter is with the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, D.C. Send correspondence to Dr. Scholle (e-mail: scholle@ncqa.org ).
authors.forename: Rita
authors.initials: R
authors.lastname: Lewis
authors.affiliation: Mr. Patel, Ms. Lewis, Dr. Liu, and Dr. Scholle are with the National Committee for Quality Assurance, Washington, D.C. Dr. Brown and Ms. Croake are with Mathematica Policy Research, Washington, D.C. Dr. Patton is with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Ms. Potter is with the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, D.C. Send correspondence to Dr. Scholle (e-mail: scholle@ncqa.org ).
authors.forename: Junqing
authors.initials: J
authors.lastname: Liu
authors.affiliation: Mr. Patel, Ms. Lewis, Dr. Liu, and Dr. Scholle are with the National Committee for Quality Assurance, Washington, D.C. Dr. Brown and Ms. Croake are with Mathematica Policy Research, Washington, D.C. Dr. Patton is with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Ms. Potter is with the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, D.C. Send correspondence to Dr. Scholle (e-mail: scholle@ncqa.org ).
authors.forename: Lisa
authors.initials: L
authors.lastname: Patton
authors.affiliation: Mr. Patel, Ms. Lewis, Dr. Liu, and Dr. Scholle are with the National Committee for Quality Assurance, Washington, D.C. Dr. Brown and Ms. Croake are with Mathematica Policy Research, Washington, D.C. Dr. Patton is with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Ms. Potter is with the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, D.C. Send correspondence to Dr. Scholle (e-mail: scholle@ncqa.org ).
authors.forename: D E B
authors.initials: DE
authors.lastname: Potter
authors.affiliation: Mr. Patel, Ms. Lewis, Dr. Liu, and Dr. Scholle are with the National Committee for Quality Assurance, Washington, D.C. Dr. Brown and Ms. Croake are with Mathematica Policy Research, Washington, D.C. Dr. Patton is with the Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration, Rockville, Maryland. Ms. Potter is with the Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services, Washington, D.C. Send correspondence to Dr. Scholle (e-mail: scholle@ncqa.org ).
authors.forename: Sarah Hudson
authors.initials: SH
authors.lastname: Scholle
mesh_terms: D006801:Humans; D008605:Mental Health Services / Q000592:standards*; D019984:Quality Indicators, Health Care / Q000592:standards*