NCQA’s Behavioral Health Quality Framework: A Roadmap for Using Measurement to Promote Joint Accountability and Whole-Person Care is a call to action. Carelon Behavioral Health is committed to delivering improved holistic health care to our membership. To support our organizational initiatives, our BH Quality team underwent a transformational process improvement utilizing the NCQA BH framework and roadmap.This presentation will focus on the methodology, measurement and deployment of improvements that resulted in improved HEDIS metrics, employee engagement rates, and outcomes. The session will include practical steps organizations can take to implement this best-in-class program.
Tool: Multiple lean six sigma tools – DMAIC for overall process improvement, different steps used fish bone diagram, 5 ‘whys’, Kaizen, repeat measurement
Problem: Transform BH Quality program to improve member outcomes.
Tool Selection: LSS is a framework that guides the team through all stages of a process improvement.
Usage: Guiding framework on process improvement.
Results: Improved employee engagement, improved HEDIS metrics and clinical outcomes.
Barriers: change management/culture change.
