Among the core features of MCC Behavioral Care's system are the following: 1) structured collection of baseline data is integrated into documentation of the initial clinical assessment of every patient; 2) longitudinal assessment occurs at six and 12 months with telephone follow-up of outcomes and satisfaction; 3) patients are assessed along multiple domains of function; and 4) clinical outcomes data can be linked to and analyzed with existing data on costs and utilization of services, as well as characteristics of providers, patients and benefits.
Already, the system has enabled MCC to identify significant predictors of treatment engagement, such as copayments less than $20 and special assistance for patients having difficulty getting to treatment appointments. It also has demonstrated the benefits of some substance abuse treatment programs on mental health, medical and functional outcomes.
Another quality information system was introduced by United Behavioral Health (Goldman, 1997; Goldman et al., 1998). The Goal-Focused Treatment and Patient Outcome system is a case management system for quality improvement through collaborative goal setting and focusing of treatment between clinicians and patients in psychotherapy.
Since 1994, data have been collected on general and individualized treatment goals at the beginning of all modalities of psychotherapy in adult members of the managed care system. Treatment and evaluation has been completed by 10,544 members (66%). Outcome is evaluated from global improvement ratings by providers and from patient satisfaction ratings from a mail survey. Ratings showed improvement at termination of treatment by 87% of the psychotherapy patients. Predictors of improvement included the absence of co-occurring disorders, participation in a higher number of treatment sessions (?12) and termination after completion of treatment goals (versus discontinuation).
The lack of agreement on outcomes measures and strategies, the report said, prompted the American College of Mental Health Administrators to invite industry, advocacy, professional, regulatory and government organizations to a summit in 1997. The purpose of the meeting was to develop a "consensus on core performance measures and strategies in mental health and substance abuse care."
The result was the specification of key outcome indicators that included mental and general health, housing, working, social and legal dimensions of function (American College of Mental Health Administrators, 1997).