Jeremy Weisz is co-founder and CEO of Greenspace Health, a mental health technology company that helps behavioral health organizations implement Measurement-Based Care (MBC) to continually improve the quality of care they deliver. Ahead of his presentation at our East Summit, we had the pleasure of sitting down with Jeremy to discuss MBC and its future within behavioral health care–read the conversation below.
What is MBC and what does its adoption currently look like within behavioral healthservices?
Measurement-Based Care (MBC) is the routine collection and use of client reported outcome measures throughout treatment to guide clinical decision making. Research shows a clear correlation between measuring progress and improved client outcomes– with MBC contributing to a 3.5x higher likelihood that a client will experience reliable change, a 42% higher overall improvement in clinical symptoms, and a 40% lower dropout or cancellation rate. It’s also recognized by accreditors like the Joint Commission as being a foundational component of evidence-based care.
While the evidence around the clinical impact of MBC is clear, less than 20% of behavioral health providers report that they consistently use MBC in practice. Now, this doesn’t mean that the remaining 80% of providers don’t believe in MBC, but it does show that we’re in the early stages of widespread adoption. When we speak to clinicians and organizations who aren’t yet measuring outcomes consistently, it’s most often the case that they want to get there, but they’re not sure where to start. The good news is that adoption is accelerating and we’re seeing more and more organizations across North America leverage MBC to get visibility into the impact of services being delivered and to improve their programs and services.
What is Greenspace doing to help bridge the gap between MBC research and its use in practice?
It’s really about making MBC as approachable as possible. We want to help organizations easily implement MBC and realize the same benefits in practice that they’ve seen in the research. We know that If it’s not accessible and approachable for everyone, it’s not going to be adopted. We work everyday to build intuitive technology to make the lives of clinical leaders, clinicians and people in care easier. And we keep each of them top of mind as we improve our platform to ensure we’re facilitating a simple, collaborative and effective process that provides value to each stakeholder.
The second piece that I’d highlight is around education and awareness. We’re big believers in always sharing the ‘why?’ behind MBC because it’s most effective when clinicians and clients understand how it will support them, are bought in and excited. Our team invests heavily in educational opportunities for the behavioral health industry– like our event series with the Yale Measurement-Based Care Collaborative– to make MBC education compelling and accessible to clinicians and clinical leaders.
Finally, we work on many coordinated implementations where multiple groups work together across a system, service type or region to collaboratively implement, and learn from one another. As an example, in Maryland we’re working with 20+ behavioral health organizations in a Community of Practice to measure and track outcomes in a consistent way across the State. The data and insights allow the organizations to benchmark results, share best practices, and ultimately improve the overall system and ensure that clients achieve the best possible outcomes.
Considering the research and your experience with over 380 clinical implementations, can you share any insights that might be helpful for clinical leaders approaching MBC implementation?
As with any big change, especially within healthcare, there will be questions or concerns from clinicians and clinical leaders. Addressing these questions early on is key to empowering them as they adapt to a new process. There are three main points that are key to highlight early on with clinical staff to help them feel confident in their implementation of MBC.
- Clients will engage. This can be a concern for clinicians where they aren’t sure if clients will complete assessments. In practice, we know that clients absolutely engage with MBC—as long as you make the process meaningful and useful for them as well. With our partner clinics, the average assessment completion rate is 81%, with a 44% improvement in symptom scores. Not only do clients engage in MBC, but it helps them further engage in the entire care process, and experience better outcomes.
- It will eliminate administrative burden. There can be a concern that MBC will be too time consuming for staff, but in our experience, we see the opposite. A well planned implementation won’t increase clinician workload. With clarity and structure around the MBC process, supported by intuitive and automated technology, MBC will alleviate work– not produce more of it.
- Clinical value comes first. MBC flips the traditional measurement model on its head by making its purpose, first and foremost, to provide clinical value to the clinician and the client– with the goal of continually improving care by boosting client engagement, therapeutic alliance, and clinical outcomes. It’s important for clinicians to know that MBC isn’t another data collection exercise used exclusively for reporting, but rather it’s a process to improve care. While organizations will have great data to leverage, the primary purpose of MBC is always to provide the insights and information needed to deliver the best possible care.
Value-based care (VBC) models continue to change the way that behavioral health services are being delivered across the US. How can MBC support the evolving requirements that follow this shift?
I don’t think anyone would disagree that behavioral health has lagged behind other areas of health care in the transition towards value-based care (VBC). In my view, there are two major pieces missing that contribute to this gap: first is a lack of objective data available on how clients are responding to treatment; and second is a lack of clarity on which metrics to use to determine if clients achieved successful outcomes.
We’re seeing MBC support these challenges in two ways. First, using MBC in a structured and consistent way allows organizations to collect the foundational data necessary to understand how their services are helping the population(s) they support. Second, the ability to easily aggregate data and present outcomes in a range of ways allows organizations to engage with payors and agree on VBC reporting requirements that both provide value to clients and meet the needs of payors.
At Greenspace, we have a customizable data dashboard that our partners leverage to facilitate collaborative discussions with payors to share the impact of their services and help them advocate for reporting models that drive improved clinical outcomes. We’re excited to be able to support these conversations and work with our partners to ensure organizations have the tools they need to help with the continued transition towards VBC.
We want to thank Jeremy for taking the time to share his thoughts with us. If you’re interested in learning more about MBC, be sure to attend Jeremy’s presentation on April 19th at the Future of Mental Healthcare East Summit.