In an effort to improve the quality and consistency of behavioral health care, the National Quality Forum (NQF) has partnered with a coalition of health plans and Headway, a national digital therapy enablement platform, to launch a pioneering initiative aimed at standardizing how behavioral health clinicians measure the progress of care. This new initiative, dubbed Aligned Innovation, addresses a significant challenge within the behavioral health industry: the lack of standardized data measurement tools. By working with key stakeholders and leveraging technology, the initiative promises to not only improve patient care but also reduce clinician workload, ultimately paving the way for a more effective and efficient system of behavioral health treatment.
For years, the behavioral health industry has struggled with a fragmented and inconsistent approach to measuring patient outcomes. The absence of a universal set of metrics for conditions such as depression and anxiety has made it difficult for clinicians to fully understand the scope of a patient’s progress. This initiative by the NQF aims to change that by creating a standardized behavioral health measurement tool that can track both symptoms and functional improvements. The goal is to create a more comprehensive picture of a patient’s well-being and recovery, which can then be used to inform treatment plans and improve care coordination across various providers and payers.
At the heart of this effort is the development of a new patient-reported outcome performance measure (PROPM) that will assess changes in symptoms over time, specifically targeting depression and anxiety. The tool will not only capture symptom severity but also measure how those symptoms are impacting a patient’s daily functioning. This approach moves beyond the traditional symptom-focused assessments, such as the PHQ-9 for depression and the GAD-7 for anxiety, by integrating functional assessment into a single, unified tool. By capturing both symptoms and functionality, the tool will offer clinicians a more well-rounded view of a patient’s progress, leading to better-informed decisions regarding care. This represents an important shift in how behavioral health measurement is used to assess patient outcomes.
Headway’s Role in the Aligned Innovation Initiative
Headway, a digital behavioral health company, has been selected as the first launch partner for this initiative. Headway operates as a platform that matches patients with mental health providers within their insurance networks and equips providers with technology solutions to reduce administrative burdens. As part of Aligned Innovation, Headway is piloting the new assessment tool with 100 of its providers, helping to test and refine the measures before their broader rollout.
“We’re trying to move from a symptom-focused assessment tool to one that, in one tool, can assess functional abilities as well,” said Dr. Jeff Gould, Senior Medical Director and Head of Headway’s Clinical Team. This shift represents a significant evolution in how behavioral health measurement is applied. By expanding the scope of the assessment tools to include functional abilities, clinicians will be able to gain deeper insights into how mental health issues affect the day-to-day lives of their patients, allowing for more targeted and effective treatment strategies.
To further support the development of the Aligned Innovation initiative, Headway has distributed a new set of patient surveys to 250 patients, gathering over 1,000 individual assessments that will be shared with the NQF. These data will be used to refine the measurement tool and assess its usability and effectiveness. Participating providers are also meeting regularly with NQF to provide feedback and ensure the measures align with clinical needs and practices.
The Impact of the Initiative on Behavioral Health Care
The Aligned Innovation project is set to last 24 months, with two main objectives: the development of an omnibus tool for measuring depression and anxiety symptoms, and the creation of a PROPM that tracks symptom changes over time. The initiative is being led by the NQF, a not-for-profit organization that has long been dedicated to improving health care quality through the development of measurement standards. The involvement of prominent health plans like CareFirst, Elevance Health, Geisinger, Kaiser Permanente, and the BlueCross BlueShield Association, among others, is critical to the success of this project. The membership of these health plans ensures that the measures developed through Aligned Innovation will be widely adopted and used across the health care system.
One of the key benefits of this initiative is the potential to reduce the fragmentation that currently exists in behavioral health measurement. As Dana Gelb Safran, President and CEO of NQF, explained, “When multiple payers in a market all align and say, ‘We’re going to all hold you, providers in our network, accountable for this measure,’ it will ensure that providers are being measured in the same way, using the same standards.” This alignment between payers will foster more consistency in care delivery and make it easier for clinicians to adopt these new measures without having to navigate multiple different systems and protocols.
Addressing Challenges in Behavioral Health Measurement
Despite the clear benefits of standardizing behavioral health measurement, there are challenges to implementing these tools. Behavioral health care is unique in that it often requires nuanced, individualized treatment plans, making it difficult to apply one-size-fits-all measures across the board. Additionally, integrating new measurement tools into existing workflows can be a complicated process, requiring technology adaptations such as changes to electronic health records (EHR) systems and adjustments in company culture to prioritize improving scores.
However, NQF has worked to address these challenges by ensuring that for every new measure introduced, at least two or more existing measures will be retired. This approach will help reduce clinician burden and prevent the addition of excessive administrative work. Furthermore, the initiative is developing a system of maternal health measures that will be easier to implement, demonstrating the flexibility of the Aligned Innovation project to adapt to different areas of health care.
Looking Toward the Future: A Unified Approach to Behavioral Health Care
The behavioral health measurement tool developed through Aligned Innovation is expected to be available by the third quarter of 2025. While it is difficult to predict when these measures will be fully adopted across the industry, the groundwork laid by this initiative is promising. By creating a more unified system for measuring mental health care, the initiative will make it easier for clinicians to track progress, improve care, and demonstrate the effectiveness of their treatments.
For Headway, this partnership is a critical part of their ongoing mission to improve behavioral health measurement and delivery through technology. “My ultimate vision would be that it’s a tool that is easily adopted by a wide variety of clinicians and able to be applied for a wide variety of problems, issues, and behavioral health struggles that our patients come to us with,” said Dr. Gould. By expanding measurement-based care tools, Headway and NQF are helping to create a future where behavioral health care is more accessible, effective, and tailored to the needs of each patient.
In conclusion, Aligned Innovation represents a major leap forward in the evolution of behavioral health measurement. By standardizing measurement tools, aligning multiple payers, and reducing clinician workload, the initiative promises to make a lasting impact on how mental health care is delivered, ultimately improving patient outcomes and paving the way for a more efficient and equitable system of care. As the initiative moves forward, it has the potential to become a cornerstone of value-based care in the behavioral health field.
