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APA case study

APA is the leading scientific and professional organization representing psychology in the United States, with more than 121,000 researchers, educators, clinicians, consultants and students as its members.

APA’s mission is to promote the advancement, communication, and application of psychological science and knowledge to benefit society and improve lives.

Challenge

Unlike other provider specialties, mental and behavioral health professionals were without a Qualified Clinical Data Registry (QCDR) to supply mental/behavioral health/psychology-focused measures beyond those Quality measures offered by CMS.

Additionally, the Quality measures that CMS did offer focusing on the psychology specialty were very limited, leaving mental/behavioral health specialists few options for MIPS reporting or for patient quality tracking.

This absence of psychology-focused measures not only made it challenging for mental/behavioral health specialists to partake in MIPS reporting and to engage in patient quality tracking, but deterred many from participating at all.

Approach

APA and Healthmonix began partnering in 2014 when the Physician Quality Reporting System (PQRS) was in place and continuously recommends Healthmonix to psychologists looking to complete PQRS/MIPS reporting, as well as for quality tracking in general.

Recognizing Healthmonix’s expertise in building QCDRs, APA approached Healthmonix in 2017 about building a QCDR focused specifically on the reporting and quality tracking needs of psychologists. This initiative not only entailed building and hosting the QCDR platform, but also included programming APA developed mental/behavioral health-focused measures and submitting the proposed measures and the QCDR self-nomination to CMS following the agency’s strict requirements and guidelines.

Healthmonix provided guidance on the measure build and oversaw the actual approval request to CMS. The initial self-nomination was successful and in 2018 the Mental and Behavioral Health Registry (MBHR)/QCDR was born. While psychologists were not required to report MIPS in 2018, the MBHR platform was available and offered as a tool for practitioners to perform Quality tracking.

CMS announced that in 2019, however, psychologists would be required to report MIPS. Healthmonix worked along-side APA to again complete the self-nomination process as well as to build additional measures for 2019. This process entailed providing data to CMS on the utilization of the measures and platform, all of which Healthmonix submitted and gained approval on behalf of APA.

Healthmonix continues to work with APA on an ongoing basis to maximize measure performance in the  MBHR.

In addition to providing unique mental/behavioral health/psychology Quality measures, the MBHR includes CMS Quality measures, giving practitioners the opportunity to report on general Quality measures (checking patient medications, etc.).

The Healthmonix-APA partnership also includes working very closely on opportunities to promote the MBHR and deliver provider education to increase the adoption of the MBHR. APA’s focus has been on continuous refinement of their Quality measures with the goal to both improve and expand available selections each year.

Impact, outcome, and results

With our partnership and focus, the MBHR has enabled practitioners to track quality outcomes on their clients and patients, utilizing measures identified by psychology as being most meaningful to clinicians. When psychologists were added to the Merit-Based Incentive Payment System (MIPS) in 2019, the MBHR became an important resource to effectively report quality outcomes to CMS. The MBHR can be used to meet board certification maintenance of competence requirements, negotiate with value-based reimbursement payment programs (i.e., pay-for-performance) and help practices remain competitive.

Client testimonial

“Developing the MBHR provided an opportunity for psychology and psychologists to take a leadership role in determining quality mental and behavioral health care. It is critically important that psychologists and other mental/behavioral health professionals have access to measures that represent how they actually practice, that are true indicators of quality outcomes, and that are most useful to the patients they serve, especially given the increasing impact it has on provider reimbursement.”

C. Vaile Wright, Ph.D.
Senior Director, Health Care Innovation
American Psychological Association