In recent years, behavioral healthcare—including care for mental health and substance use disorders—has become a pressing issue for employers, yet they struggle with how to provide employees with access to quality care.
For employers that carve out behavioral healthcare or whose health plan contracts these services to another organization, an additional challenge is ensuring that their partner offers access to quality care and coordinates between behavioral and medical care.
NCQA’s Managed Behavioral Healthcare Organization (MBHO) Accreditation program evaluates organizations on whether they implement industry best practices to provide high-quality behavioral healthcare.
What Is MBHO Accreditation?
NCQA-Accredited organizations must demonstrate that they follow evidence-based practices for providing high-quality care across multiple standards. MBHO Accreditation emphasizes care coordination, complex case management and data exchange between health plans and behavioral health organizations.
The MBHO standards focus on:
- Quality Management and Improvement: The MBHO has processes to monitor, evaluate and improve the quality and safety of care provided, including practitioner availability, behavioral health screening programs and complex case management.
- Care Coordination: The MBHO coordinates care among behavioral health practitioners and between behavioral healthcare and medical care.
- Utilization Management: Utilization management is a critical component of accreditation. The MBHO demonstrates, through extensive record review, that it adheres to a process that ensures members are receiving decisions on treatments that are timely and evidence-based.
- Credentialing: The MBHO has and follows processes for verifying and monitoring the credentials of practitioners in its network.
- Member Experience: The MBHO ensures a positive member experience and follows processes for handling member complaints and appeals.
What Does MBHO Accreditation Mean for Employers?
For employers trying to determine how to ensure that their employees receive quality behavioral healthcare, the MBHO Accreditation program provides a framework for evaluating potential partners.
A health plan or a separate MBHO that meets NCQA standards assures employers that they have a partner in improving and maintaining the behavioral health of their workforce.
Employers that contract with Accredited MBHOs know that these organizations continually monitor, evaluate and improve the quality and safety of care provided to members.
What Should Employers Do?
Employers need to ask their current or prospective health plans or behavioral health organizations if they have met NCQA standards.
Find information about Accredited plans on NCQA’s Report Cards.
Have a question? NCQA’s Employer Relations Team can help!