Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Health Services Research
Published in: BMC Health Services Research 1/2021

Open Access 01-12-2021 | Psychotherapy | Research article

The implementation potential of a method to monitor empirically-supported children’s mental health treatment through claims data

Authors: Sarah Cusworth Walker, Noah Gubner, Aniyar Iztguttinov, Felix Rodriguez, Paul Davis, Aaron Lyon, Suzanne Kerns, Eric Bruns, Jiage Qian, Georganna Sedlar

Published in: BMC Health Services Research | Issue 1/2021

Login to get access

Abstract

Background

The delivery of evidence-supported treatments (EST) in children’s mental health could be a valuable measure for monitoring mental healthcare quality; however, efforts to monitor the use of EST in real world systems are hindered by the lack of pragmatic methods. This mixed methods study examined the implementation and agency response rate of a pragmatic, claims-based measure of EST designed to be applied as a universal quality measure for child psychotherapy encounters in a state Medicaid system.

Methods

Implementation potential of the EST measure was assessed with healthcare leader rankings of the reporting method’s acceptability, appropriateness and feasibility (n = 53), and post-implementation ratings of EST rate accuracy. Ability of the healthcare system to monitor EST through claims was measured by examining the agency responsivity in using the claims-based measure across 98 Medicaid-contracted community mental health (CMH) agencies in Washington State.

Results

The analysis found the reporting method had high implementation potential. The method was able to measure the use of an EST for 83% of children covered by Medicaid with 58% CMH agencies reporting > 0 ESTs in one quarter. Qualitative analyses revealed that the most significant barrier to reporting ESTs was the operability of electronic health record systems and agencies’ mixed views regarding the accuracy and benefits of reporting.

Conclusions

Measurement of child mental health ESTs through Medicaid claims reporting has acceptable implementation potential and promising real world responsiveness from CMH agencies in one state. Variation in reporting by agency site and low to moderate perceived value by agency leaders suggests the need for additional implementation supports for wider uptake.
Literature
1.
deLone SE, Hess CA. Medicaid and CHIP children’s healthcare quality measures: what states use and what they want. Acad Pediatr. 2010;11(3):S68–76.CrossRef
2.
Institute of Medicine (US) Committee on Crossing the Quality Chasm: Adaptation to Mental Health and Addictive Disorders. Improving the Quality of Health Care for Mental and Substance-Use Conditions: Quality Chasm Series. Washington (DC): National Academies Press (US); 2006.
3.
Children’s Health Insurance Program Reauthorization Act of 2009. 2009.
4.
Bardach NS, Burkhart Q, Richardson LP, Roth CP, Murphy JM, Parast L, et al. Hospital-based quality measures for pediatric mental health care. Pediatrics. 2018;141(6):e20173554.PubMedCrossRef
5.
6.
Zima BT, Murphy JM, Scholle SH, Hoagwood KE, Sachdeva RC, Mangione-Smith R, et al. National quality measures for child mental health care: background, progress, and next steps. Pediatrics. 2013;131 Suppl 1(1):S38.PubMedCrossRef
7.
8.
Pincus HA, Scholle SH, Spaeth-Rublee B, Hepner KA, Brown J. Quality measures for mental health and substance use: gaps, opportunities, and challenges. Health Aff (Project Hope). 2016;35(6):1000.CrossRef
9.
Houtrow AJ, Zima BT. Framing childhood mental disorders within the context of disability. Disabil Health J. 2017;10(4):461–6.PubMedCrossRef
10.
Ng MY, Weisz JR. Annual research review: building a science of personalized intervention for youth mental health. J Child Psychol Psychiatry. 2016;57(3):216–36.PubMedCrossRef
11.
Michel-Lepage A, Ventelou B. The true impact pf the French pay-for-performance program on physicians’ benzodiazepines prescription behavior. Eur J Health Econ. 2016;17(6):723–32.PubMedCrossRef
12.
13.
Fortney JC, Unützer J, Wrenn G, Pyne JM, Smith GR, Schoenbaum M, et al. A tipping point for measurement-based care. Psychiatr Serv. 2017;68(2):179–88.PubMedCrossRef
14.
Zima BT. Measurement-based data to monitor quality: why specification at the population level matter? Child Adolesc Psychiatr Clin N Am. 2020;29(4):703–31.PubMedCrossRef
15.
Richardson LP, Ludman E, McCauley E, Lindenbaum J, Larison C, Zhou C, et al. Collaborative care for adolescents with depression in primary care: a randomized clinical trial. JAMA. 2014;312(8):809–16.PubMedPubMedCentralCrossRef
16.
Sedlar G, Bruns EJ, Walker SC, Kerns SEU, Negrete A. Developing a quality assurance system for multiple evidence based practices in a statewide service improvement initiative. Adm Policy Ment Health Ment Health Serv Res. 2017;44(1):29–41.CrossRef
17.
Schoenwald S, Garland A, Chapman J, Frazier S, Sheidow A, Southam-Gerow M. Toward the effective and efficient measurement of implementation fidelity. Adm Policy Ment Health Ment Health Serv Res. 2011;38(1):32–43.CrossRef
18.
Bumbarger B, Campbell E. A state agency-university partnership for translational research and the dissemination of evidence-based prevention and intervention. Adm Policy Ment Health Ment Health Serv Res. 2012;39(4):268–77.CrossRef
19.
Barth RP, Lee BR, Lindsey MA, Collins KS, Strieder F, Chorpita BF, et al. Evidence-based practice at a crossroads: the timely emergence of common elements and common factors. Res Soc Work Pract. 2012;22(1):108–19.CrossRef
20.
Park AL, Tsai KH, Guan K, Chorpita BF. Unintended consequences of evidence-based treatment policy reform: is implementation the goal or the strategy for higher quality care? Admin Pol Ment Health. 2018;45(4):649.CrossRef
21.
Chorpita B, Bernstein A, Daleiden E. Driving with roadmaps and dashboards: using information resources to structure the decision models in service organizations. Adm Policy Ment Health Ment Health Serv Res. 2008;35(1):114–23.CrossRef
22.
Bruns EJ, Kerns SEU, Pullmann MD, Hensley SW, Lutterman T, Hoagwood KE. Research, data, and evidence-based treatment use in state behavioral health systems, 2001-2012. Psychiatr Serv (Washington, DC). 2016;67(5):496.CrossRef
23.
Dorsey S, Berliner L, Lyon AR, Pullmann MD, Murray LK. A statewide common elements initiative for children’s mental health. J Behav Health Serv Res. 2016;43(2):246–61.PubMedPubMedCentralCrossRef
24.
Weisz JR, Jensen-Doss A, Hawley KM. Evidence-based youth psychotherapies versus usual clinical care: a meta-analysis of direct comparisons. Am Psychol. 2006;61(7):671–89.PubMedCrossRef
25.
McLeod BD, Southam-Gerow MA, Jensen-Doss A, Hogue A, Kendall PC, Weisz JR. Benchmarking treatment adherence and therapist competence in individual cognitive-behavioral treatment for youth anxiety disorders. J Clin Child Adolesc Psychol. 2019;48:S234–S46.PubMedCrossRef
26.
Chorpita B, Daleiden E, Weisz J. Identifying and selecting the common elements of evidence based interventions: a distillation and matching model. Ment Health Serv Res. 2005;7(1):5–10.PubMedCrossRef
27.
Warren JS, Nelson PL, Burlingame GM, Mondragon SA. Predicting patient deterioration in youth mental health services: community mental health vs. managed care settings. J Clin Psychol. 2011;68(1):24–40.PubMedCrossRef
28.
Gopalan G, Goldstein L, Klingenstein K, Sicher C, Blake C, McKay MM. Engaging families into child mental health treatment: updates and special considerations. J Can Acad Child Adolesc Psychiatry. 2010;19(3):182–96.PubMedPubMedCentral
29.
Walker SC, Sedlar G, Berliner L, Rodriguez F, Davis P, Johnson S, et al. Advancing the state-level tracking of evidence-based practices: a case study. Int J Ment Heal Syst. 2019;13(1):25.CrossRef
30.
Agency for Healthcare Research and Quality. Pediatric quality measures program (PQMP) centers of excellence grant awards. 2012.
31.
Thomas CP, Garnick DW, Horgan CM, Miller K, Harris AHS, Rosen MM. Establishing the feasibility of measuring performance in use of addiction pharmacotherapy. J Subst Abus Treat. 2013;45(1):11–8.CrossRef
32.
Iyer SP, Spaeth-Rublee B, Pincus HA. Challenges in the operationalization of mental health quality measures: an assessment of alternatives. Psychiatr Serv. 2016;67(10):1057–9.PubMedCrossRef
33.
Southam-Gerow MA, Daleiden EL, Chorpita BF, Bae C, Mitchell C, Faye M, et al. MAPping Los Angeles county: taking an evidence-informed model of mental health care to scale. J Clin Child Adolesc Psychol. 2013;43(2):1–11.PubMed
34.
Hogue A, Bobek M, Dauber S, Henderson CE, McLeod BD, Southam-Gerow MA. Distilling the core elements of family therapy for adolescent substance use: conceptual and empirical solutions. J Child Adolesc Subst Abuse. 2017;26(6):437–53.PubMedPubMedCentralCrossRef
35.
Weisz JR, Chorpita BF, Palinkas LA, Schoenwald SK, Miranda J, Bearman SK, et al. Testing standard and modular designs for psychotherapy treating depression, anxiety, and conduct problems in youth: a randomized effectiveness trial. Arch Gen Psychiatry. 2012;69(3):274–82.PubMedCrossRef
36.
Dorsey S, McLaughlin KA, Kerns SEU, Harrison JP, Lambert HK, Briggs EC, et al. Evidence base update for psychosocial treatments for children and adolescents exposed to traumatic events. J Clin Child Adolesc Psychol. 2017;46(3):303–30.PubMedCrossRef
37.
Hogue A, Henderson CE, Becker SJ, Knight DK. Evidence base on outpatient behavioral treatments for adolescent substance use, 2014–2017: outcomes, treatment delivery, and promising horizons. J Clin Child Adolesc Psychol. 2018;47(4):499–526.PubMedPubMedCentralCrossRef
38.
Hoagwood K, Essock S, Morrissey J, Libby A, Donahue S, Druss B, et al. Use of pooled state administrative data for mental health services research. Adm Policy Ment Health Ment Health Serv Res. 2016;43(1):67–78.CrossRef
39.
Weiner BJ, Lewis CC, Stanick C, Powell BJ, Dorsey CN, Clary AS, et al. Psychometric assessment of three newly developed implementation outcome measures. Implement Sci. 2017;12(1):108.PubMedPubMedCentralCrossRef
40.
Hsieh H, Shannon S. Three approaches to qualitative content analysis. Qual Health Res. 2005;15(9):1277–88.CrossRef
41.
Walker SC, Hurvitz P, Leith J, Weiss N. Gaps analysis of research/evidence-based treatment for children’s public mental health in Washington state: Division of Behavioral Health and Recovery, Department of Social and Health Services, Washington State; 2014.
42.
Walker S, Hurvitz P, Leith J, Rodriguez F, Endler G. Evidence-based program service deserts: a geographic information systems (GIS) approach to identifying service gaps for state-level implementation planning. Adm Policy Ment Health Ment Health Serv Res. 2016;43(6):850–60.CrossRef
43.
Cuellar AE, Haas-Wilson D. Competition and the mental health system. Am J Psychiatry. 2009;166(3):278–83.PubMedCrossRef
44.
Coordinated Care. 2018 Provider and billing manual. 2017.
45.
McCormick KA, Moore SR, Siegel R. Clinical practice guideline development : methodology perspectives: US Department of Health and Human Services, Public Heath Service, Agency for Health Care Policy and Research; 1995.
46.
Aarons GA, Hurlburt M, Horwitz SM. Advancing a conceptual model of evidence-based practice implementation in public service sectors. Adm Policy Ment Health Ment Health Serv Res. 2011;38(1):4–23.CrossRef
Metadata
Title
The implementation potential of a method to monitor empirically-supported children’s mental health treatment through claims data
Authors
Sarah Cusworth Walker
Noah Gubner
Aniyar Iztguttinov
Felix Rodriguez
Paul Davis
Aaron Lyon
Suzanne Kerns
Eric Bruns
Jiage Qian
Georganna Sedlar
Publication date
01-12-2021
Publisher
BioMed Central
Keyword
Psychotherapy
Published in
BMC Health Services Research / Issue 1/2021
Electronic ISSN: 1472-6963
DOI
https://doi.org/10.1186/s12913-021-07317-z

Other articles of this Issue 1/2021

BMC Health Services Research 1/2021 Go to the issue

Research article

Synergies and fragmentation in country level policy and program agenda setting, formulation and implementation for Global Health agendas: a case study of health security, universal health coverage, and health promotion in Ghana and Sierra Leone

Research article

What if something happens tonight? A qualitative study of primary care physicians’ perspectives on an alternative to hospital admittance

Research article

Barriers, knowledge, and training related to pharmacists’ counselling on dietary and herbal supplements: a systematic review of qualitative studies

Research article

Rural and urban differences in patient experience in China: a coarsened exact matching study from the perspective of residents

Research

How to improve the quality of care for people on home mechanical ventilation from the perspective of healthcare professionals: a qualitative study

Research

Professionals’ responses to the introduction of AI innovations in radiology and their implications for future adoption: a qualitative study