1.  Why did PBH develop the Honors for Outcomes practitioner Honor Roll?
PBH is committed to making people’s lives better.  The Honors for Outcomes practitioner Honor Roll system has been developed in response to increasing consumer demand for meaningful information about health care practitioners to help guide their decisions about whom to select for the treatment of mental health and substance abuse problems.  PBH believes that the Honor Roll list helps our members make better informed choices when seeking behavioral health care services, and that the Honors for Outcomes program provides important recognition for those practitioners who have helped their patients achieve above average clinical outcomes.
 
2.  How does PBH measure practitioner performance?
Performance is determined by the positive clinical changes among a practitioner’s patients.  PBH practitioners have their patients complete clinical outcome questionnaires during the course of outpatient treatment.  These questionnaires measure the level of distress a patient is experiencing.  Clinical progress is monitored by the treating practitioner and by PBH during treatment, and the total amount of change is calculated based on a comparison of the initial questionnaire with the most recent one.  PBH compares individual patient improvement to the typical gains made by individuals with similar characteristics and initial levels of distress.  Practitioners are evaluated according to the average amount of improvement achieved by all their patients.  Practitioners qualify for the Honors for Outcomes Honor Roll list if they have submitted data on at least ten patients over a three year period, and those patients have demonstrated clinical improvement that is reliably above average.
 
Note:  All practitioners in the PBH network are experienced, licensed professionals.  The PBH Honors for Outcomes program does not evaluate the performance of practitioners outside of the PBH network.  The Honors for Outcomes Honor Roll program is currently only available for PBH network practitioners in the following states: California, Colorado, Oklahoma, Oregon, New Mexico, Texas, and Washington.
 
3.  Should I avoid practitioners who are not on the Honors for Outcomes list?
All PBH-contracted practitioners have met the industry’s highest credentialing requirements.  These high standards ensure that PBH members always have access to quality practitioners. 
There are several reasons why a practitioner may not appear on the Honor Roll.   First, the practitioner may have insufficient numbers of patients submitting clinical questionnaires during the past three years.  Second, the practitioner’s patients may not, on average, be showing better than average clinical improvement compared to similar types of patients.  Third, the outcomes of patients of the practitioner may be variable: To be on the Honor Roll, the outcomes of patients of the practitioner must be reliably above average. 
 
It is also important to remember that there are many other factors that should be considered when choosing a quality practitioner.  The Honors for Outcomes list should be just one consideration.
 
4.  Is the information shared on the clinical outcome questionnaires confidential?  Can it be shared with others beyond the treating practitioner and PBH?
 
Member information is always kept confidential and is not shared without a member’s written authorization to release that information to another party.  Federal law mandates that practitioners and healthcare organizations must protect the confidentiality of member and patient information as stipulated by the Health Insurance Portability and Accountability Act (HIPAA).  To learn more about HIPAA guidelines go to www.hhs.gov/ocr/hipaa or call 866-627-7748.
 
5.  What if there are no Honors for Outcomes practitioners in my area?  
The Honors for Outcomes Honor Roll is not a provider directory. Always make sure to check the PBH Online Provider Directory at www.pbhi.com to see a complete listing of all the highly qualified PBH network providers in your area. There are many critical factors to consider in choosing the right practitioner.  Clinical specialty, level of clinical training, office location, appointment hours, and the practitioner’s gender are considered important factors by many people.  You can always get help in selecting a PBH practitioner by calling a PBH customer service associate.  They are available 24 hours a day, seven days a week to answer your questions, and can be reached by calling the toll-free PBH number in your area.  Whatever your decision, you can feel confident that the PBH-contracted practitioner you visit has been reviewed based on PBH criteria and the industry’s highest credentialing requirements as defined by the National Committee for Quality Assurance.
 
Note: In the case of an emergency or crisis situation, always call 911 or go immediately to the nearest hospital or emergency room for care.
 
6.  My benefit plan offers me the option of going to practitioners outside of PBH’s network.  Can the practitioner I select still use the PBH outcome questionnaires during my treatment? 
At this time, only contracted PBH practitioners have access to our clinical outcome questionnaires.  Your practitioner may call 1(800)716-1166 if he or she is interested in joining the PBH network.  However, new practitioners will be required to meet PBH credentialing standards.
 
7.  I notice that very few MDs and nurse practitioners in your network are on the Honor Roll, and I wonder why that is so?
PBH does not require MDs and other prescribing practitioners to have their patients complete the LSQ, and as a result few of them qualify.  Very often when a prescribing practitioner is treating a patient, a therapist is also treating that patient.  We only ask the therapists to administer the outcome questionnaires to avoid unnecessary repetition for patients.
 
8.  Do clinicians who receive the “Honors for Outcomes” designation receive any extra financial compensation?
Clinicians do not receive any financial compensation as a result of this designation. 
 
9.  Did PBH practitioners know that they were being evaluated on their outcomes?
All practitioners submitting questionnaires to PBH have been receiving feedback on a quarterly basis on how their outcomes compare with established norms.  The Honors for Outcomes Honor Roll is a new recognition system introduced in 2005 to acknowledge clinicians with above average results.
 
10.  How frequently is the Honors for Outcomes Honor Roll list updated?
The Honor Roll list is updated on a quarterly basis.
 
11.  Couldn’t providers submit fake or altered clinical outcome questionnaires in order to get on the Honor Roll?
We believe providers understand the clinical importance of the clinical outcome questionnaires and would not engage in this type of fraudulent behavior.  Nevertheless, PBH does monitor provider data submission in order to detect suspicious patterns, and has the contractual right to review patient records if necessary in order to verify the accuracy of the data submitted.  In addition, PBH will periodically review the program criteria and determine whether additional criteria need to be added to further deter any dishonest data submission practices.