9
Oct

Improve Member Satisfaction of Behavioral Health Treatment among the Severely Mentally Ill Population

By: Linda Sookman, Behavioral Health Quality and Accreditation Consultant at Morpace

Member experience outcomes are subjective based on an individual’s perceived reality. It is important to consider that members who are severely mentally ill (SMI) may already have a distorted perception of reality due to their illness. So how do you improve members’ experience of behavioral health treatment within this specific population?

In our work at Morpace, we know how challenging it can be to achieve satisfaction among SMI members. Factors such as the severity of an individual’s mental illness, medical complications, and comorbid substance use play a distinct role. The degree of family and community support, treatment compliance, and socioeconomic status are also critical to their overall perception of care.

With these considerations in mind, we can utilize a combination of healthcare analyses and actionable processes to increase comprehensive satisfaction and improve outcomes.

How to Improve Your SMI Members’ Satisfaction, Based on Data

In 2011, the Agency for Healthcare Research and Quality (AHRQ) published the National Quality Strategy (NQS) to define a framework for national healthcare policy on healthcare quality improvement. The Centers for Medicare and Medicaid Services (CMS) adopted the same approach in defining the value of quality healthcare. If you are one of the many MHBOs working to improve your SMI population’s member experience, I recommend leveraging these ideas that occur within the three aims of the NQS framework:

Aim #1 – Provide Better Care

Strive to improve the overall quality of care by making the healthcare you provide more person-centered, reliable, accessible, and safe. This includes:

Education: In order to promote positive outcomes, your members, caregivers, network, and clinical staff should understand the importance of shared decision-making to improve expectations of treatment, treatment planning, and goal setting.

  • Assessment: Work to understand and quantify the members’ caregiver(s)’ experience in both treatment and planning, while utilizing the appropriate member consent process.
  • Encouragement: Leverage member and family-centered interactive behavioral health self-management tools to improve both member and caregiver’s management of their illness, adherence to treatment recommendations, and positive experiences to stimulate better outcomes.
  • Integration: Explore the level of integration of behavioral and medical services within your network and community. This process includes identifying gaps and developing innovative interventions to address them. It’s also essential to coordinate local community resources into the members’ treatment plan, such as self-help groups, along with publicly funded sources for housing, financial, transportation, nutritional, legal, and vocational training services.
  • Evaluation: Conduct quarterly access and availability evaluations in coordination with member compliance and grievance data to ensure members have easy and timely contact with credentialed behavioral health prescribers and non-prescribers. This should be based on clinical urgency while simultaneously meeting the needs and preferences of the member population.
  • Nurturing: Create and implement a quality-focused culture among your internal leadership, staff, and external stakeholders. These people and parties include network practitioners, providers, acute care facilities, PCPs, medical specialists, pharmacies, and local community organizations. Seek internal and external stakeholders’ feedback on a regular basis. Brainstorm opportunities for improvement in developing innovative clinical and service programs.

Aim #2 – Engage in Smarter Spending

Work to reduce the cost of quality healthcare for individuals, families, employers, government, and communities. You can do this by:

  • Focusing on the voice of your member: This approach generates a 360-degree view of experience from multiple data sources. Conduct member experience surveys, and review member complaints and grievances. Additional insights can also be gained through member and caregiver focus groups, as well as social media within the constraints of the HIPAA Privacy Rules and 42 CFR, Part 2.
  • Considering new service delivery models: Determine which avenues could reduce your organization’s healthcare costs, such as value-based payment models, monthly case rates, integrated payment models, or capitated networks.
  • Refocusing reimbursement of treatment to value based quality care: Collaborate with network providers on outcomes that demonstrate quality and value.
  • Assessing the effectiveness of current programs: How well are they working against the cost to implement them? Evaluate the expenditures and staffing resources needed to efficiently promote population health management, and carry out innovative programs such shared-decision making and transitions of care rather than having licensed case management staff designated for data entry.

Aim #3: Promote Healthier People and Communities

Improve the health of Americans by supporting proven interventions to address behavioral, social, and environmental determinants of health while delivering higher-quality care. Achieve this by:

  • Conducting useful patient analyses: Administer SMI patient stratification analyses and develop behavioral health screening programs for high-risk SMI members as part of secondary and tertiary prevention.
  • Promoting wellness: Incentivize your members to access their community health and wellness improvement programs.
  • Encouraging peer support: Identify Peer Support Specialists within the local community to encourage positive treatment experiences to improve the quality of life for this high-risk, high-cost member population.
  • Sponsoring Integrated Medical and Behavioral (IMBH) activities: Sponsor community health and wellness fairs, educational seminars, or preventive health/wellness focused events.
  • Improving patient communication strategies: Assess the methods and frequency of your organization’s patient communications. Aim to reach a larger circle of patients through text messaging, e-appointment reminders, or other digital communications which are preferred modes by younger members.
  • Considering new health and wellness strategies: Promote wellness programs based on the special needs of the population in collaboration with national or local sponsors, such as NAMI or local community services.

Keep in mind, the more positive your SMI members’ experiences are, the greater reduction in costly behavioral health and medical expenditures you will have, the healthier the member population will be. Morpace has the tools and expertise that can lead to improved member experiences and provider satisfaction. If you would like to discuss this further, or have any questions, please contact me, Linda Sookman, RN, BSN, CPHQ, Lean Six Sigma Green Belt, Behavioral Health Quality and Accreditation Consultant, at 248.756.0532 or lsookman@morpace.com.

References:

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3538837/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4780300/
  3. https://pmj.bmj.com/content/79/932/337
  4. https://ps.psychiatryonline.org/doi/10.1176/appi.ps.201700359
  5. https://www.ncqa.org/programs/health-plans/population-health-management-resource-guide/
  6. https://nrchealth.com/wp-content/uploads/2018/01/Real-time-for-Millennials-Research-Brief.pdf

 

More