Table 2.
Barriers | Leverage opportunities in learning health care systems | |
---|---|---|
Patients |
Medical and behavioral health conditions co‐occur The majority of patients are still seen in small primary care practices |
Adopt mental health measurement‐based care (continuous use of validated outcome assessments that inform changes in treatment decisions) Consumer organizations link patients to recovery‐oriented services in the region |
Providers |
The majority of providers lack training in quality improvement and evidence‐based practice implementation Lack of incentives for non‐mental health providers to incorporate mental health services where patients are more likely seen (e.g., primary care), and lack of integration with social services |
Professional organizations mandating training in quality measurement and improvement methods Same‐day billing for mental health and physical health care Mental health professional organizations adopt common quality measures, guidelines, and improvement strategies |
Practices/Organizations |
Limited electronic medical record use in the majority of mental health sites Lack of effective strategies to scale up and spread evidence‐based mental health treatments and models of care |
Standard health information exchanges need to include mental health services Embed quality improvement experts to help identify, test and scale up treatment models to promote measurement‐based care |
Purchasers/ National health systems | Primarily fee for service, few bundled payment models | Plan‐level mental health care coordination |
Instability in health insurance markets | Value‐based reimbursement payment models benchmark on improved quality rather than volume | |
Population | Stigma | Public reporting of quality measures |