For decades, the behavioral health industry has lacked a unified and scalable system for defining, measuring, and improving clinical outcomes. The absence of standardized quality measures has long been considered one of the greatest barriers to true value-based care in mental health and substance use treatment. Now, the National Council for Mental Wellbeing, a leading voice in the behavioral health sector, is taking a bold step toward addressing this gap through the adoption of measurement-informed care in behavioral health.
In a recent webinar, the Washington, D.C.-based nonprofit introduced a new framework for quality assessment called measurement-informed care in behavioral health. This approach is intended to replace the widely used but often misunderstood concept of measurement-based care, which many in the field believe has not fully captured the complexity of behavioral health decision-making.
The change is more than semantic. It’s a strategic pivot toward a more nuanced, contextually grounded, and scalable model for using clinical data—one that supports innovation, accountability, and patient-centered care at both the provider and system levels.
Why Change the Terminology? From “Based” to “Informed”
For many years, measurement-based care has been the go-to term for data-informed clinical practice in behavioral health. The concept centers around the routine collection of standardized patient assessments to guide treatment decisions. While this model has improved care consistency in some settings, critics argue that it oversimplifies the complexity of human behavior and recovery.
According to Dr. Henry Chung, professor of psychiatry at the Albert Einstein College of Medicine and a key thought leader in the Council’s initiative, the terminology itself may be holding the field back. He explained that measurement-based care often implies a rigid framework where clinical decisions are made solely on the basis of limited, often self-reported, quantitative data.
“Measurement alone is not sufficient as a sole process for making treatment decisions,” Chung stated. “We know because of the nature of our instruments, largely because they are patient-reported, that measurement errors can occur.”
These errors, he noted, may stem from both providers and patients, and any clinical data must be interpreted within the broader context of social determinants of health, equity considerations, patient preferences, and health literacy. In other words, while data can enhance care, it cannot be the sole driver.
Thus, the Council is promoting measurement-informed care in behavioral health as a more accurate and holistic term—one that better reflects the real-world dynamics of clinical decision-making.
The Vision Behind Measurement-Informed Care in Behavioral Health
At its core, measurement-informed care in behavioral health builds upon the foundational principles of measurement-based care but expands them in critical ways. It promotes the use of validated, repeatable outcome measures, including patient-reported outcomes (PROs) and biometric data, but within a broader framework that emphasizes:
- Contextual interpretation of data
- Shared decision-making
- Consideration of patient individuality and life circumstances
- Integration with social, cultural, and systemic factors
This vision also aligns measurement with value-based care—a payment model that ties reimbursement to the quality of care provided rather than the quantity of services delivered. For years, behavioral health stakeholders have pointed to the absence of standardized, reliable quality measures as a major obstacle to adopting value-based contracts. Without widely accepted metrics, payers struggle to define what they’re paying for, and providers struggle to demonstrate the value of their work.
Measurement-informed care in behavioral health offers a path forward.
A Two-Tiered Approach to Outcome Measurement
In the webinar, the National Council previewed a significant forthcoming report, developed over the past year through its Center of Excellence for Integrated Health Solutions. The report, expected to be released later this year, will lay out a framework of standardized outcome measures designed to serve as the foundation for clinical decision-making and payment innovation.
While the full list of measures has not yet been disclosed, the Council revealed a two-tiered classification system for organizing outcome measures according to their purpose, evidence base, and clinical utility.
Tier 1: Federally Aligned, High-Impact Measures
Tier 1 measures are those that are already endorsed or required by authoritative bodies in health care quality, including:
- Medicaid
- Certified Community Behavioral Health Clinic (CCBHC) program standards
- National Committee for Quality Assurance (NCQA)
- U.S. Preventive Services Task Force (USPSTF)
These measures are characterized by:
- Alignment with national reporting and regulatory standards
- Clinical relevance to outcomes (not process or epidemiological measures)
- Potential for use in accountability and payment models
By focusing on measures already integrated into federal programs, Tier 1 provides a ready-to-implement foundation that supports immediate action, particularly in settings like CCBHCs that are already navigating value-based contracts and quality reporting requirements.
Tier 2: Transdiagnostic, Patient-Centered Measures
Tier 2 measures offer a more flexible, innovative complement to Tier 1. They are designed to be:
- Transdiagnostic (applicable across a range of conditions)
- Patient-reported
- Low-burden to administer
- Responsive to change over time
These measures enable clinicians to assess progress and well-being across diverse patient populations, even in the absence of a single diagnostic category. They are particularly valuable for longitudinal care planning, therapeutic alliance building, and real-time clinical adjustments.
“With Tier 2, we see this as an opportunity for the field to begin thinking creatively and broadly about the most meaningful concepts,” said Deborah Scharf, associate professor of psychology and health sciences at Lakehead University. “These are measures that from our perspective indicate savings and quality and that are broadly applicable across all of the populations that we serve.”
At present, both tiers focus on adult patient populations, but the Council noted that pediatric outcome measures are a priority for future development.
The Problem of Nonstandardized Measures
The drive toward measurement-informed care in behavioral health is a response to a long-standing problem in behavioral health: the absence of industry-wide standards for quality measurement.
In medical care, rigid technical standards—such as those for electrical safety or pharmaceutical dosage—promote reliability and public trust. In contrast, behavioral health lacks such cohesion.
“Part of the reason our appliances run great is that we have very rigid standards for how the electricity gets measured and put out,” said Dr. Joseph Parks, medical director for the National Council for Mental Wellbeing. “Part of the reason health care runs poorly is that we can’t agree on standards.”
This lack of consensus creates friction across the ecosystem. Payers are left without clear benchmarks to assess performance. Providers face inconsistent reporting expectations. And patients experience wide variations in care quality depending on where they seek treatment.
“I support anybody that’s pushing us to standardize,” Parks added. “I don’t know if payers are the best to do it, but if they are in a position to make us standardize, then God bless them. If the regulators are in a position to make us standardize, God bless them. It doesn’t always feel good, but it will do us good.”
Implications for Value-Based Care
The National Council’s embrace of measurement-informed care in behavioral health has significant implications for the broader shift toward value-based care (VBC) in behavioral health.
Historically, the behavioral health sector has lagged behind primary care and specialty medicine in the adoption of VBC models. A major reason for this has been the lack of agreed-upon, outcomes-based metrics that reflect the complexity of behavioral conditions.
Measurement-informed care in behavioral health is designed to bridge that gap. By grounding clinical decisions and payment models in reliable, standardized data—interpreted within the real-life context of patient experience—the approach offers a path forward for:
- Payers seeking to build outcomes-based contracts
- Providers aiming to demonstrate the impact of their services
- Patients wanting more transparent, personalized, and effective care
- Policymakers developing regulatory frameworks that prioritize both equity and efficacy
The forthcoming report from the Council promises to offer a blueprint for using these measures not just to track performance but to transform systems—from how care is delivered to how it’s funded.
What’s Next?
While the National Council’s new framework has generated significant interest, the field now awaits the publication of the full report. The Council has not provided an exact release date, but the document will reportedly detail the criteria and selection process behind the Tier 1 and Tier 2 measures, and offer guidance on how providers, payers, and policymakers can implement measurement-informed care in behavioral health across diverse settings.
For many in the field, the shift represents a long-overdue opportunity to standardize what has long been inconsistent—and to elevate the behavioral health system to one that is more accountable, data-driven, and person-centered.
Conclusion: A Step Toward a Stronger Behavioral Health System
The move from measurement-based care to measurement-informed care in behavioral health marks a pivotal evolution in how the behavioral health industry conceptualizes quality and accountability. Rather than viewing data as a rigid directive, the new model treats measurement as a tool to inform, not dictate, care—one that can integrate clinical nuance, equity considerations, and patient voice into every step of the treatment process.
By introducing a two-tiered system of outcome measures, the National Council for Mental Wellbeing is not only helping to set the stage for better care but also laying the foundation for value-based payment models that reward real progress, not just activity.
As the field continues to mature, measurement-informed care in behavioral health may prove to be the framework that finally unites stakeholders around a shared vision of quality—grounded in data, responsive to complexity, and committed to the wellbeing of every individual served.
