March 26, 2012
Last month, the National Committee for Quality Assurance (NCQA) released the new quality measures for treating schizophrenia and bipolar disorder. (See Seven New HEDIS Medicaid Measures Target Schizophrenia, Bipolar Disorder ). The final comment period closed on March 14 and the measures will likely be added to the 2013 Healthcare Effectiveness Data and Information Set (HEDIS). (If you’re not familiar with HEDIS, it is a set of performance measures, developed and maintained by the NCQA. At the present time, the only HEDIS measures focused on mental health deal with antidepressant medication management, follow-up after hospitalization for . . .

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Integrated Care Models

Integrated care models have become a basic premise for service delivery in the health and human service field. Stemming from the focus on comprehensive whole-person health, integrated care models include the complete array of services for a person’s health and well-being—physical health, behavioural health, pharmacy benefits, and social supports. For health and human service provider organizations, there are many possibilities to serve consumers by taking a whole person approach to health care. From care coordination initiatives and addressing the social determinants of health to integrating primary and behavioural health care, payers and health plans are looking for a holistic approach when it comes to managing complex consumer populations.


The New Jersey Department of Health (NJDOH) plans to create a single, integrated license for outpatient health care facilities that will allow the license holders to deliver integrated primary care, mental health, and addiction treatment services, as described in a new proposed rule. NJDOH anticipates that the integrated license will enable delivery of comprehensive, whole-person care, leading to improved health outcomes and a better consumer experience. Currently, provider organizations seeking to provide integrated care, primary… Read