Less is more: Virginia's Performance Outcomes Measurement System.

Abstract

Public mental health authorities are faced with the responsibility of containing costs, improving quality, and providing greater accountability. In response, a number of states began developing mechanisms to assess consumer outcomes and provider performance. In the late 1990s Virginia took a proactive stance by pilot testing the Performance and Outcome Measurement System (POMS), which was based on the ConsumerOriented Report Card of the Mental Health Statistics Improvement Program (MHSIP). The Virginia Department of Mental Health, Mental Retardation, and Substance Abuse Services implemented the pilot project at eight sites. Implementing POMS statewide was intended to serve two major purposes: it would continuously improve the quality of services, and it would increase accountability for taxpayer dollars. POMS was designed by a committee that included major stakeholder groups: consumers, family members, and providers. This committee also oversaw the implementation of the pilot project and obtained input from a wider array of stakeholders throughout the implementation process. In early 1997 six community mental health centers and two state hospitals were selected to participate in the pilot project. Two sites each were selected to represent adult mental health, child and adolescent mental health, adult substance abuse, and inpatient services. A total of 46 different indicators were tested across the four populations. The goals of the pilot project were to determine which of these indicators provided the most useful information at the lowest cost and to develop recommendations for improving POMS and for implementing the program statewide. The pilot project took place from 1997 to 1999.