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MANAGING MANAGED CARE: QUALITY IMPROVEMENT IN BEHAVIORAL HEALTH
2.3.1 Promoting the improvement and use of performance measures for managed care.
2.3.2 Monitoring and studying the use and effectiveness of quality assurance, accreditation, performance measures, and outcomes measurements.
2.3.3 Establishing minimum standards for accreditation organizations to achieve deemed status (i.e., when the government, in its role as purchaser of managed care services, accepts accreditation as a measure of adequate quality and consumer protection).
Role of State Governments
2.4 The role of state governments in consumer protection should include the following:
2.4.1 Support the development of consumer protection standards for managed behavioral health care by state mental health and substance abuse agencies, state Medicaid agencies, state insurance departments, state licensing boards, state hospitals, and state child welfare agencies. State consumer groups, such as the chapters of the National Mental Health Association (NMHA), National Depressive and Manic Depressive Association (NDMDA), National Association for Research on Schizophrenia and Depression (NARSD), and National Alliance for the Mentally Ill (NAMI), should be included in the development of standards.
2.4.2 Maintain the minimum necessary regulatory standards, including the use of accreditation, to assure consumer protection while encouraging innovations in the delivery of care.
2.4.3 Consider offering deemed status to specific accreditation organizations that meet state-defined standards for quality of managed behavioral health care services.
Roles of All Levels of Government
2.5 Both federal and state governments should:
2.5.1 Encourage the development of report cards or other similar materials to help inform consumers and families about specific plans and the quality of care.
2.5.2 Include all stakeholders (accreditation organizations, employers, state agencies, consumers, families, providers, and practitioners) in the development, implementation, and use of standards.
2.6 Because managed care methods are increasingly applied to public systems, accreditation bodies and managed care plans should evaluate the inclusion