Measurement-Based Care: A Practical Strategy Toward Improving Behavioral Health Through Primary Care

Abstract

Behavioral health care access is inadequate and new primary care-based strategies are needed to meet the rising demand. Behavioral health integration (BHI) models, such as collaborative care (CoCM) or the primary care behavioral health (PCBH) model, are often touted as actionable and sustainable solutions. The intent of such models is to bring behavioral health expertise into medical settings with the aims of improving outcomes, increasing treatment capacity, and reducing stigma. BHI models differ across several parameters, though measurement-based care (MBC) is a key component of virtually all effective approaches. MBC employs the repeated and timely use of validated instruments to inform medical decisionmaking for individual patients at the point of care and has a demonstrated association with improved outcomes. MBC generally has more flexibility for workflow development and fewer financial, staffing, and IT requirements than CoCM, PCBH, or other models. It can also be implemented by primary medical providers independently. Recent encouraging developments include technical assistance opportunities for MBC implementation and emerging payment models that emphasize MBC. However, concerns remain surrounding the limitations of existing MBC billing codes. Ultimately, with continued advocacy and thoughtful policy decision-making, MBC has the potential to be a solution to the current behavioral health crisis.