Monitor and Improve Behavioral Health Services With Member Feedback

Tackling the ongoing behavioral health crisis is one of the big challenges facing health plans. When left untreated, mental illnesses and substance use issues contribute to high emergency room utilization rates, reduced life expectancies and lower health outcomes. The resounding economic impact of these conditions is felt throughout the industry, but Medicaid, the largest payer of behavioral health services, faces most of the costs.

Improving access to mental health and substance use services enables health plans to impact health outcomes and reduce healthcare costs. By equipping members with the right tools to manage their mental health or substance use issues, health plans can achieve higher quality scores and better cost savings.

To ensure these programs are delivering meaningful care, plans need to assess member experiences. Understanding how members feel about these services and identifying opportunities to improve quality of care allows health plans to accelerate financial growth. The most effective tool for improving mental health and substance use program performance is a behavioral health survey.

What is the ECHO Survey?

The Experience of Care and Health Outcomes (ECHO) survey measures member experiences with receiving behavioral health care and is one of the most effective behavioral health surveys. It is a type of Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey designed for treatment provided by Managed Care Organizations, including Medicaid plans and Children's Health Insurance Programs (CHIP). This behavioral health survey evaluates member experiences through 17 measures, including how easy it is to get treatment, how well clinicians communicate and overall health plan rating. Agency for Healthcare Research and Quality AHRQ has designed surveys for adults and children.

While similar to the national CAHPS Health Plan survey, the ECHO survey differs in three main ways. First, the ECHO survey is administered at a state level. State regulators may choose to link quality incentives to specific ECHO measures to encourage Medicaid plans to address member pain points in receiving and addressing behavioral health issues. States may also choose to include supplemental mental health-related questions in the official CAHPS survey instead of administering ECHO surveys.

Second, the national CAHPS survey is administered by a government-approved survey vendor, while the ECHO survey is conducted by individual health plans. Health plans may employ a third-party vendor to conduct ECHO surveys.

Third, federally sponsored health plans like Medicare Advantage plans are not required to conduct ECHO surveys.

What is Measured in a Behavioral Health Survey?

Behavioral health satisfaction surveys ask similar questions to the CAHPS Health Plan survey, but focus specifically on interactions with behavioral health, mental health and substance use services. The ECHO Survey contains 63 questions for both adults and children, including questions to determine a member’s age, gender, ethnicity and education level. Most questions inquire about services received in the past 12 months.

Questions include:

• Did you get counseling, treatment or medicine for depression, anxiety, personal problems, family problems, substance use issues or a mental illness?
• Did you need to get counseling or treatment right away?
• How many times did you go to an emergency room or crisis center to get counseling or treatment for myself?
• Were you given information about different kinds of counseling or treatment that are available?
• How much of a problem, if any, were delays in counseling or treatment while you waited for approval from your health plan?
• Does your language, race, religion, ethnic background or culture make any difference in the kind of counseling or treatment you need?

Based on a member’s responses, the survey will evaluate providers and health plans across 17 different measures, including:

• Getting treatment quickly
• How well clinicians communicate
• Getting treatment and information from the plan
• Perceived improvement
• Information about treatment options
• Overall rating of counseling and treatment
• Overall rating of health plan
• Office wait times
• Told about medication side effects
• Discussed including friends and family in treatment
• Given information to manage condition
• Informed about patient rights
• Confidence in treatment privacy
• Cultural competency of clinicians
• Amount helped by treatment
• Provided information about receiving treatment after benefits are used up

Why are Behavioral Health Surveys Important?

Behavioral health services are vital for equipping members with the tools, habits and mindsets they need to manage their health. Research into Oregon’s Medicaid program determined that expanding coverage and improving access to care reduced untreated depression by more than 60% and an overall improvement in symptoms. For health plans, this translates to lower costs of providing emergency room care and stronger performance in quality incentive programs. State agencies are aware of the importance of these programs and are making efforts to improve their effectiveness.

Behavioral health satisfaction surveys like the ECHO survey provide a window into member challenges in receiving behavioral health treatment. Monitoring member experiences allows health plans and regulators to determine how willing members are to engage in their care, identify barriers to care and evaluate the effectiveness of behavioral health programs. Expanding access to Medicaid coverage and mental health services has improved the mental health of members and reduced diagnoses for depression.

By addressing member pain points with data-driven interventions, plans can improve engagement, increase program effectiveness and reduce the economic burden of unmet conditions.

Administering Behavioral Health Surveys to Address Program Performance

The ECHO survey is the most comprehensive method of evaluating member experiences with behavioral health services and identifying opportunities to improve program functionality. While state agencies like Oklahoma or North Carolina may require Medicaid and CHIP plans to conduct the survey through incentive programs, plans may also conduct the survey at any time to capture feedback and design meaningful interventions.

Surveying 63 questions to every member who receives behavioral health services is a costly and time-consuming process that may alienate members, however. Instead, plans should trickle these questions throughout their health journeys to alleviate the burden on members and continuously monitor program performance. Trimming surveys down to specific measures or pain points also allows plans to reduce survey costs while refining data collection.

Monitor member experiences with mental health or substance abuse treatment with Healthmine’s Pulse Surveys. Pulse Surveys equip plans with comprehensive survey tool for administering behavioral health surveys at scale through targeted outreach. Medicaid and CHIP plans can quickly distribute white-labeled emails and text messages to reduce reliance on physical outreach and minimize processing times. With the support of our Expert Advisory Services team and a dedicated account manager, you can determine the best strategy for improving member experiences and accelerating program performance.

Increase the utilization and effectiveness of behavioral health services when you use Pulse Surveys to identify opportunities for improvements.