ABSTRACT
Among the 250 million Americans with health insurance, 164.1 million (66%) are enrolled in some type of managed behavioral health program (Oss, Jardine, & Pesare, 2002). The proliferation of managed behavioral health care services provided by health insurance plans and managed behavioral health care organizations (MBHOs) has created a demand among consumers, purchasers, and policy makers for evidence of the quality of treatment provided. A number of projects have developed such indicators (Eisen & Cleary, 2001; Eisen et al., 1999, 2001; Hall & Flynn, 1997; National Committee For Quality Assurance, 2002; Ross, 1997; Teague, Ganju, Hornik, Johnson, & Mckinney, 1997). Patient reports about their treatment and the outcomes of treatment are a part of all the major sets of indicators and are important information for quality assessment and improvement efforts (Berwick, 2002; Cleary, Edgman-Levitan, 1997; Institute of Medicine, 2001, 2003). Many behavioral health treatment providers use information from consumer surveys as part of their internal quality improvement and monitoring efforts (Hermann, Regner, Erickson, & Yang, 2000; Shaul et al., 2001). Another reason for monitoring patient experiences is that bad treatment experiences are associated with treatment avoidance, low trust, changing providers, failure to adhere to treatment recommendations, and poor clinical outcomes (Holcomb et al., 1998; Larsen et al., 1979; Fremont et al., 2001; Kaplan, & Ware, 1989; Keating et al., 2002; Lied, Sheingold, Landon, Shaul, & Cleary, 2003).
