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The Department of Behavioral Health Provider Scorecard is a tool designed to help users of public behavioral health services in the District of Columbia select a provider that best meets their needs. Through a rigorous application process, the Department of Behavioral Health certifies community based providers to deliver behavioral health services for children, youth and adults. As part of its ongoing oversight to ensure high quality services, the Department developed the Provider Scorecard to rate providers on service delivery. The Provider Scorecard rates the quality of service delivery in assessment, treatment planning and coordination of care. It also examines financial compliance with federal and local regulations and laws.
To be included, a provider must demonstrate paid claims for a minimum of 15 consumers for services delivered during all four quarters of the review period. As such, every certified community provider may not be included in each review period.
The Provider Scorecard comprises two domains—a Quality domain and a Financial domain. The primary source of data for the Quality domain of the Provider Scorecard is extracted from the annual quality reviews conducted by the DBH Office of Accountability. These reviews consist of site visits and chart abstractions made at each community provider. The samples for these reviews are randomly chosen. The numbers of reviews conform to industry sampling practice based on the size of the population seen by a provider. For 1-300 clients, 15 charts are reviewed; for 301-1,000 clients, 20 charts are reviewed, and for providers with more than 1,000 clients, 25 charts are reviewed.
The Financial section includes the results of the Department’s claims audit process and monitoring of provider compliance with financial regulations.
The FY 2012 Provider Scorecard is based on data elements from Fiscal year 2012 (October 1, 2011 through September 30, 2012) except in the case of the MHRS Claims Audit results. Since claims audits are conducted retrospectively the claims audit results used for the Scorecard will be the most recent fiscal year audit completed across all CSAs. The FY10 MHRS Claims Audit results will be used for the 2012 Provider Scorecard. The FY10 MHRS Claims Audit examined claims for dates of service October 1, 2009 through September 30, 2010.
For more information about the Provider Scorecard or the FY 2012 Technical Specification Manual, please contact the Deputy Director of Accountability at (202) 673-2245.
FY 2011 Provider Scorecard
The Quality Reviews conducted in 2011 cover the period April 1, 2010 through March 31, 2011. For more information about the Provider Scorecard or the Technical Specification Manual, please contact the Office of Accountability at (202) 673-2245.