Project Summary

Background: Measuring quality outcomes in mental health care has been limited by fragmented care delivery, data insufficiency, reliance on claims-based medication use/adherence measures, and underuse of screening tools to identify patients with behavioral health needs. To improve patient experience and quality, broad adoption of patient-reported outcomes measures (PROMs) is needed. However, implementation and use of PROMS have been limited due to administrative challenges, perceived patient burden, and lack of consensus on appropriate methods. Consensus methods for deploying PROMs and demonstration of feasibility and impact will facilitate provider investment in building capacity, and ultimately scalability.

Proposed Solution to the Problem: Through this PCORI Engagement Award, PBGH seeks to convene leading plans, providers, and stakeholders with demonstrated success in implementing PHQ-9 screening and use of depression screening and remission measures for patient engagement, quality improvement, and care redesign. By bringing together plans, purchasers, providers, consumers, and policy makers, the project team can identify best practices and key research questions that address administrative challenges, perceived patient/provider burden, and build consensus methods. In addressing myriad infrastructure issues and engaging stakeholders on outcomes reporting and using data for comparative effectiveness research, the team hopes to reinforce the value of integrating purchaser and consumer perspectives, and ultimately improve outcomes for depression and apply lessons to improving other behavioral health outcomes. 

Project objectives include: 

  • Enhancing stakeholder engagement in PCOR and CER and understanding their value to purchasers, patients, and providers
  • Demonstrating successful purchaser and patient participation as stakeholders
  • Capturing purchaser and patient perspectives in PCOR design 

By simultaneously advancing broad use of patient-reported outcome measures (PROMs), this project has the added benefits of promoting: expanded use of PHQ-9 for depression screening; use of PROMs to engage patients in treatment choice and understanding of their care plan; use of PROMs for quality measurement and provider performance accountability; and behavioral health integration in primary care. 

Activities: PBGH will convene providers, patients, and consumer advocates and key stakeholders to identify and prioritize key barriers to provider and patient engagement in PROMs. These convenings will foster information sharing about approaches to research on care processes across health systems that serve diverse populations and reflect different payer mixes. 

Projected Outcomes and Outputs: Input on success factors in overcoming these barriers to depression screening and PROMs collection, along with mapping key drivers of change will support knowledge transfer via toolkits and methodology briefs. The team will identify methods that build capacity for depression screening, which ultimately impact access to appropriate interventions and treatment, and which in turn can enable broader outcomes measurement for other mental health conditions.

Patient and Stakeholder Engagement Plan: PBGH will engage provider organizations, purchasers, and patients/consumer organizations through workgroups that will provide input to a national stakeholder committee. A collaborative learning approach will streamline administrative processes and simplify infrastructure requirements, ultimately reducing provider burden. Input from patient partners as stakeholders will also help spread effective techniques for patient communication and engagement.

Project Collaborators: PBGH will coordinate efforts with the Integrated Healthcare Association, California Quality Collaborative, public and private purchasers that comprise PBGH’s Behavioral Health Advisory Group, and government entities.

Project Information

Emma Hoo
Purchaser Business Group on Health

Key Dates

21 months


Project Status
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: September 9, 2022