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Variation in Stakeholder Preferences for Implementing Evidence-Based Practices in Behavioral Health Care
Molly Candon1, Nathaniel Williams1, Kelly Zentgraf1
1Department of Psychiatry, Center for Mental Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Candon, Zentgraf, Beidas, Stewart); Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Candon, Buttenheim, Stewart); School of Social Work, Boise State University, Boise, Idaho (Williams); Center for Health Incentives and Behavioral Economics, Perelman School of Medicine, and Department of Family and Community Health, School of Nursing, University of Pennsylvania, Philadelphia (Buttenheim); Department of Medicine and Department of Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia (Bewtra); Penn Implementation Science Center (PISCE@LDI), Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia (Beidas).
Objective:
The authors examined whether stakeholders in behavioral health care differ in their preferences for strategies that support the implementation of evidence-based practices (EBPs).
Methods:
Using data collected in March and April 2019 in a survey of stakeholders in Philadelphia Medicaid’s behavioral health care system, the authors compared empirical Bayes preference weights for implementation strategies across clinicians, supervisors, agency executives, and payers.
Results:
Preferences for implementation strategies overlapped among the stakeholders (N=357 survey respondents). Financial incentives were consistently ranked as most useful and performance feedback as the least useful for implementing EBPs. However, areas of divergence were identified. For example, payers preferred compensation for EBP delivery, whereas clinicians considered compensation for time spent on preparing for EBPs as equally useful.
Conclusions:
The observed variation in stakeholder preferences for strategies to implement EBPs may shed light on why the ongoing shift from volume to value in behavioral health care has had mixed results.
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