The National Association for Behavioral Healthcare (NABH) has been a leader in a unique public/private partnership since 2001, working to develop a set of clinical measures that providers could use to compare and continuously improve their performance across all inpatient hospital-level psychiatric treatment settings. The initiative began with staff and board level discussions among leaders of The National Association of State Mental Health Program Directors (NASMHPD), the NASMHPSD Research Institute (NRI, Inc.) and NABH.
Milestones in the public/private partnership include the following:
- Representatives of NASMHPD, NRI, Inc., and NABH met to explore ways the organizations could collaborate to further their individual performance measurement goals.
- The three organizations signed a Teeming Agreement, formalizing the relationship and agreeing to develop performance measures for public and private mental health system hospital services.
- The organizations led a “proof of concept” exploratory data collection effort, including 22 volunteer facilities, of both public- and private-sector hospitals. Analysis of the effort confirmed the organizations’ commitment to proceeding with the project and readiness to reach out to other partners.
- The Joint Commission and the American Psychiatric Association (APA) were asked to joined the collaborative and, with the founding partners, hosted a 24-member stakeholders meeting that included consumers, family members, providers, and researchers to provide input into the measurement framework.
- The NABH, NASMHPD, NRI, Inc., (APA), and Joint Commission formally announced their intent to “identify a set of standardized, core measures for hospital-based, in-patient psychiatric services.”
- A Technical Advisory Panel (TAP), comprised of relevant stakeholders, was formed to oversee the core measurement development project.
- Extensive measure identification specification work took place over almost two years.
- More than 195 hospitals from both the public and private sectors volunteered to formally pilot test the proposed measures.
- The TAP approved the measure set and recommended it for implementation.
- The Hospital Based Inpatient Psychiatric Services (HBIPS) core measure set became available for use by all psychiatric hospitals and psychiatric units in general hospitals.
- The core measure set was submitted to the National Quality Forum (NQF) for endorsement. Measures two through seven were formally endorsed.
- The Joint Commission made reporting of the HBIPS core measure set mandatory for all psychiatric hospitals. HBIPS ccould be selected for reporting by psychiatric units in general hospitals.
- The Centers for Medicare and Medicaid Services (CMS) appointed a Technical Expert Panel (TEP) to guide the development of quality measures for inpatient psychiatric hospitals and psychiatric units pursuant to Section 3401 subsection 10322 of the Patient Protection and Affordable Care Act (ACA). All collaborators in the original public/private partnership were appointed to the TEP.
- Members of the TEP recommended HBIPS measures two through seven for inclusion in the CMS requirements for public reporting. CMS accepted the recommendation.
- CMS issued a proposed rule announcing their selection of HBIPS two through seven as the measures that would be required of all psychiatric hospitals (both public and private) and psychiatric units in general hospitals that are reimbursed under the Inpatient Psychiatric Facility Prospective Payment System (IPF PPS).
- CMS announced that, in order to avoid a 2% reduction in their payment update, IPF PPS hospitals would be required to report data on HBIPS two through seven. Data from admissions beginning October 1, 2012 (Rate Year 2013) would need to be used for payment purposes.
- All collaborators in the original public/private partnership continue to be appointed members of the TEP that will advise the Department of Health and Human Services (HHS) in their ongoing measurement development initiatives.