PTE Behavioral Health Reporting

Welcome to the Pathways to Excellence, Behavioral Health Web page! Here you can learn about an exciting opportunity to be involved in public reporting related to behavioral healthcare quality, and to find out more details regarding how to do so.

The things you will find here are:

For Outpatient Mental Health and Substance Abuse Providers

    • letter inviting licensed outpatient mental health and/or substance abuse providers to participate in public reporting with directions regarding how to do so.
    • Submission/Attestation form which must be completed by the first business day of the month prior to the quarterly GetBetterMaine.org website update. For the July website update, for example, the attestation form must be submitted by the first business day of June. Website updates occur on the first business day of January, April, July and October.
    • Domains of Quality Behavioral Health Graphic.
    • An excel spreadsheet to complete with your demographic information for sites/organizations with more than two providers who wish to participate.  This same worksheet may be used to update your demographic information and provider list as it changes.

For Behavioral Health Case Management Services

We are referring here to behavioral health case managers who fall under the MaineCare Sections of 13, 17 and 92; Section 13: Targeted Case Management Services, Section 17:  Community Support Services, and Section 92: Behavioral Health Home Services. For a complete description of these sections, please refer to: https://www1.maine.gov/sos/cec/rules/10/ch101.htm in the 10-144 Department of Health and Human Services Chapter 101: MaineCare Benefits Manual.

    • A letter inviting agencies who provide case management services under MaineCare Sections 13, 17 and 92 to participate in public reporting with directions regarding how to do so.
    • Submission/Attestation form which must be completed by the first business day of the month prior to the quarterly GetBetterMaine.org website update. For the July website update, for example, the attestation form must be submitted by the first business day of June. Website updates occur on the first business day of January, April, July and October. The first submission/attestation form is due December 2, 2016.
    • Domains of Quality Behavioral Health, Case Management Graphic.

State Innovation Model (SIM) Award and the Maine Health Management Coalition (MHMC)

The Maine Health Management Coalition (MHMC) has been publishing data on the quality of healthcare online for more than a decade through its Pathways to Excellence (PTE) Program. We believe that this transparency has contributed to improving the quality of healthcare delivered in our state. Over seven years ago employers began using the information on our website, www.GetBetterMaine.org. Since then, Maine has experienced and maintained the largest jump in quality improvement from 12th to 1st in the nation for overall healthcare quality according to the Agency for Healthcare Research and Quality.

The PTE Program publicly reports healthcare quality information on acute care hospitals and ambulatory primary care and specialty practices in the state of Maine, and has been reporting on outpatient behavioral healthcare (mental health and substance abuse) since January of 2015. This information is publicly available on our website, GetBetterMaine. This transparency work began in March of 2014 when a PTE Behavioral Health (BH) Steering Committee formed. This effort, through funding from the SIM award, involves behavioral healthcare providers, health systems, consumers, employers, and health plans from across the state.

The first groups of behavioral health providers who were invited to participate were licensed outpatient behavioral healthcare (mental health and substance abuse) practitioners, sites and practices. Recently, on October of 2016, organizations which offer case management services (13, 17 and 92) have been invited to participate.

The Pathways to Excellence, Behavioral Health Steering Committee is very pleased to continue this effort! We are working hard to develop an accurate list of behavioral healthcare providers and their addresses in Maine; however this is a difficult task. If for some reason you have not been mailed an invitation to participate, please contact us and we would be happy to walk you through the process.

For the initial round of reporting, outpatient mental health and substance abuse providers were identified for inclusion based on medical claims they had submitted for services through Q1 2014.  A subset of CPT codes was identified by the steering committee which represented the outpatient counseling which they had determined should be the focus for this initial public reporting.  A list of all providers with commercial or MaineCare claims for any of these CPT codes was compiled.  From there, providers with specialties which placed them outside of the realm of behavioral health were excluded.  The remaining providers were invited to participate, either through the agencies where they were billing their services, or on an individual basis if they were individual practitioners.

Our PTE Behavioral Health Steering Committee meetings are open and we welcome additional participation at our future committee meetings. Please contact us using the information below if you are interested in actively participating. If you have any questions, please do not hesitate to contact Patti Ross, PTE Behavioral Health Director, at the PTE Program Office at the Maine Health Management Coalition at PTE@mehmc.org or at 207-844-8106.