Convene an Expert Panel on Evidence-Based Standards for Psychosocial Interventions for Mental Disorders

The Program Support Center on behalf of the Assistant Secretary for Planning and Evaluation (ASPE) within the Department of Health and Human Services intends to negotiate and award a purchase order to the Institute of Medicine (IOM), a subsidiary of the National Academy of Sciences (NAS), on a sole source basis under the authority of FAR 13.106-1(b)(1)(i). This project supports convening an expert panel to develop a framework for establishing quality standards for psychosocial treatment for mental disorders (inclusive of addictive disorders). The panel will discuss the state of the science on psychosocial treatment for mental health disorders and develop consensus on a coordinated, national effort to measure implementation of these treatments. The Affordable Care Act calls for health care delivery system reforms and innovations that rely heavily on putting more health services under budgeted systems. These include accountable care organizations, health homes, bundled payment system, coordinated care entities, and other forms of managed care. Thus, health care delivery systems will be under new pressures to save money and limit care. Without traditional fee-for-service transactions to keep track of utilization and access, these systems will rely on performance measurement to monitor how patients are treated. Moreover, accountability will increasingly take the form of linking performance and quality measures to economic rewards such as shared savings. In this way, these measures are being used to counter-balance the effect of the incentives to reduce spending and help ensure appropriate access to and quality of care. For behavioral health care, performance related to pharmacological management of patients is simpler and better developed than is measurement of psychosocial treatments. As a result, treatment has increasingly shifted away from psycho-social care possibly to the detriment of patient well-being. Unfortunately, the field has lagged behind in the development of measures to allow one to track whether the content of psychosocial treatment is consistent with evidence-based treatment and what clinical science has shown to work. The lack of established measures for psychosocial treatment, given the new emphasis on quality measurement, may result in a further reduction in the utilization of these empirically validated treatments and further constrict patient choice. In response to these concerns, this project will establish an ad hoc committee of experts that will marry clinical science with performance and quality measurement to develop a path forward for improving the quality of psychosocial interventions. The committee will explore strategies that different stakeholders might take to help establish these standards for psychosocial treatments. Specifically, the goal is to convene a special committee that will characterize the types of scientific evidence and processes needed to establish the effectiveness of psychosocial interventions by: - Defining levels of scientific evidence based on their rigor; - Defining the types of studies needed to develop performance measures for monitoring quality of psychosocial therapies and their effectiveness; and Defining the evidence needed to determine active treatment elements as well as their dose and duration Using the best available evidence, the committee will also identify the elements of psychosocial treatments that are most likely to improve a patient's mental health and can be tracked using performance and quality measures. In addition, it will identify features of health care delivery systems involving psychosocial therapies that are most indicative of high quality care that can be practically tracked as part of a system of performance or quality measures. The following approaches should be considered: - Measures to determine if providers implement treatment in a manner that is consistent with evidence-based standards; - Measures that encourage continuity of treatment; - Measures that assess whether providers have the structures and processes in place to support effective psychotherapy; - Consumer-reported experiences of evidence-based psychosocial care; and - Consumer-reported outcomes using a measurement-based care approach. The work of this special committee should focus on three major areas: determining evidence-based standards for modalities, quality and outcome performance measures for individual treatments, and provider training and certification. The initial step will be to establish a working definition of psychosocial treatments. Further deliberations and discussions emanating from this expert panel should result in the definition of the scope of the problem/issues in each of the three areas identified, and an identification of a range of solutions/recommendations. The interactions of the committee should produce a robust approach that combines clinical science with quality and performance measurement, formulating a path forward for widely-accepted measures for psychosocial therapies that are informed by the latest science on effectiveness. National Academy of Sciences (NAS) through its subsidiary the Institute of Medicine (IOM) is the only source reasonably available for the following reasons: The IOM was chartered by Congress in order to provide a source of unbiased advice to the Federal Government on policy matters pertaining to the health of the public. This project will require a contractor with experience convening and balancing the interests of a variety of stakeholders including scientific researchers, health care providers, practitioners, consumers, professional associations, and the public and private entities that are the payers for psychosocial health care services. The IOM is uniquely positioned due to the nature of its charter and mission to identify the relevant partners and stakeholders, garner their participation due to its existing structures and reputation, and to deliver findings and recommendations that minimize bias and the interests of any one stakeholder. IOM's recommendations are widely accepted because their findings result from a rigorous consensus building process. Because there are multiple stakeholders concerned with the future of psychosocial treatments, some with countervailing interests, objective and acceptable findings are paramount to generating useful policy guidance and ensuring recommendations that serve the public interest. No solicitation document is available. All responsible sources that have the requisite qualifications to perform the work described above may submit a statement of capabilities electronically to James Horkan at james.horkan@psc.hhs.gov. Responses are due by September 12, 2013 by 3:00 pm. Responses will not be accepted after the due date. If no capability statements are received which specifically demonstrate the ability to perform the requirements above, the Government shall proceed with negotiating a sole source purchase order to the Institute of Medicine (IOM).