During turbulent times for behavioral health providers that depend largely on government funding, it becomes essential to articulate the value of the organization’s services. Providers will succeed in delivering this message only if they have high-quality data at their disposal, says Michael W. Johnson, senior managing director of behavioral health at CARF International.
Providers ultimately have little control over federal and state policy decisions that could dramatically affect Medicaid and other public support, but they can double down on the effort to demonstrate that they are careful stewards of government dollars. A systematic approach to performance measurement can greatly assist this effort. CARF has responded to this need in the provider community by including in its 2025 Behavioral Health Standards Manual a new standard for measurement-informed care.
Practicing measurement-informed care poses several challenges for behavioral health providers, Johnson says. Some measurement tools are costly for organizations to apply. Behavioral health also is not as numbers-driven as other branches of health care, so traditionally there has been less standardization of clinical approaches.
The intent statement for standard 2.A.12 in CARF’s Behavioral Health Standards Manual reads, “Measurement-informed care is a clinical practice that involves the systematic use of standardized tools/measures to track symptoms and functional status of persons served over time. By regularly assessing progress, clinical personnel can make more informed treatment decisions and improve outcomes for the persons served.” CARF will begin applying the new standard on July 1.
Programs meeting the measurement-informed care standard will implement written procedures that identify the measurement tools they will use, prescribe time intervals for their administration, specify how the results obtained in measurement will be shared with persons served, and identify the necessary topics to cover in personnel training.
CARF emphasizes that the process should be patient-centered. The selected measurement tools, whether for general mental health, a specific disorder, or broader quality-of-life factors, should align with each patient’s needs and goals. Organizations should share the results obtained from assessment tools with patients, as a vehicle to enhance patient motivation and to promote shared decision-making.
According to the standard, staff training requirements could include education on why measurement-informed care needs to be implemented, as well as technical guidance for administering the tools. All in all, “This is a big lift if organizations haven’t been doing it before,” Johnson says. Yet providers that can’t document that they are implementing sound evidence-based practices could find themselves at serious risk in an unstable fiscal environment.
Amid the uncertainties always facing safety-net providers of care, a focus on measuring and managing performance becomes essential to survival. We are proud to do business with CARF and all organizations that are committed to advancing quality in substance use and mental health service delivery.
