The National Committee for Quality Assurance has published guidelines that could give employers and insurance agents a new tool for evaluating treatment of depression, alcoholism and other behavioral health problems.
The Washington group recently released the first working version of its Behavioral Health Accreditation Standards.
To earn accreditation, organizations must show they give members ready access to appointments, use reasonable policies when limiting treatment, maintain proper records, and ensure that participating doctors, nurses and counselors have the right credentials. Organizations also must offer members a formal grievance procedure.
NCQA will begin accepting accreditation applications this month. Independent behavioral health organizations that want accreditation will have to meet the standards this year.
NCQA said it would apply the standards to the behavioral health operations of full-service managed care organizations in 1999.
NCQA has been accrediting full-service managed care organizations since 1994. It later appointed a working group to create the behavioral health program. (See NU, April 22, 1996.)
Representatives for behavioral care consumer groups said they were still studying the final accreditation standards and could not comment on the program. Earlier, some groups had complained the standards gave too little attention to results-oriented standards, such as the record of an organization in helping people with manic depression get back to work.
Clarke Ross, a spokesman for the American Managed Behavioral Healthcare Association, Washington, said his members' main concern was equity: they wish NCQA were applying the review process to all managed care organizations at the same time.
Waiting until 1999 to apply the standards to full-service managed care organizations will put the behavioral care specialists at a competitive disadvantage, he said.
But association members support the accreditation effort and will see how the accreditation standards work before offering detailed criticism, Mr. Ross said.
'We need a national body with a good reputation that's going to be involved in accreditation,' Mr. Ross said.
Dr. Ian Shaffer, chief medical officer at Value Behavioral Health, Falls Church, Va., agreed that organizations will have to wait to see how the accreditation standards will work. 'We're going to have to live through it for a few years, ' he said. 'We learn more as we go along.'
The new accreditation program could save some companies time and money, Dr. Shaffer said.
Many managed care companies that use Value Behavioral Health require it to participate in their own accreditation reviews. Once Value Behavioral Health has its own independent accreditation, it no longer will have go through separate reviews for each partner, he said.
