1. Making behavioral healthcare more objective and data-driven for better outcomes

2. Why Measurement-Based Care?

3. The Problem
1 in 4 U.S. adults experience mental illness in a given year1
Medical costs for patients with mental health/substance abuse comorbidities can be up to 3 times higher than for those without.
Additional medical costs incurred as a result of mental health comorbidities are estimated to be $293 billion.
$26-48 billion could be saved annually through more effective management of behavioral health conditions.2
1National Alliance on Mental Illness (2013). Mental Illness Facts and Numbers
2Milliman, Inc. (2014). Economic impact of integrated medical-behavioral healthcare.

4. “YOU CAN’T MANAGE THAT WHICH YOU DON’T MEASURE” - –W. Edwards Deming
The Problem
“YOU CAN’T MANAGE THAT WHICH YOU DON’T MEASURE” - –W. Edwards Deming
A focus solely on outcomes only tells you what happened – measuring the process can tell you HOW it happens so you can replicate what works and improve what doesn’t

5. 77% 50% 95% The Problem You cannot manage what you do not measure…
Behavioral healthcare has poor measurement systems and inconsistent outcomes
77%
50%
95%
Average therapist effectiveness1
Effectiveness of top-performing therapists3
Self-perceived therapist effectiveness2
1Imel, Z. E., Sheng, E., Baldwin, S. A., & Atkins, D. C. (2015). Removing very low-performing therapists: A simulation of performance-based retention in psychotherapy.
2Walfish, S., McAlister, B., O'Donnell, P., & Lambert, M. (2013). An investigation of self-assessment bias in mental health providers.
3Saxon, D., & Barkham, M. (2012). Patterns of therapist variability: Therapist effects and the contribution of patient severity and risk. 5

6. Lack of behavioral health measurement creates a vicious cycle
Inability to prove BH efficacy
Lower BH reimburse-ment
Lower BH prioritization
Lower budget for BH
No BH technology tools
Mark & team

7. …of clinicians routinely use measurement systems1
Studies prove patient feedback from measurement systems improves behavioral health outcomes but are still rarely used
“Virtually all randomized controlled trials with frequent and timely feedback of diagnostic-specific, patient-reported symptom severity to the provider during the clinical encounter found that outcomes were significantly improved compared to usual care across a wide variety of mental health disorders.” 1
<20%
…YET
…of clinicians routinely use measurement systems1
Note – lead right into Mirah solution which emphasizes team approach 1

8. Mirah: Company & Solution
Mirah is a software and services company committed to making measurement-based care (MBC) achievable for all behavioral health providers.
Our solution combines leading software tools with expert clinical consulting for better outcomes and reduced system costs through patient feedback-informed treatment.

9. Mirah’s MBC solution is easy as 1, 2, 3…
Members fill out regular assessments
(MIRAH Measure) 3 2
Leadership reviews practice-level results
(MIRAH Admin)
Clinicians review progress with members
(MIRAH Track)

10. Thank You Matt Kastantin VP of Development 202.213.4969

11. What our customers say about us
“Mirah is our new way of doing things.”
--Director of Behavioral Health at Tri-City Health Center
“How does anyone who sees this software not instantly fall in love with it?”
--Outpatient Director at Community Care Alliance
“Mirah has set an incredibly high bar. I’ve never seen any company so responsive in my life!”
--Vice President at Community Care Alliance

12. Patient Feedback Topic
Research shows that more effective care results when clinicians incorporate regular patient feedback into treatment
Patient Feedback Topic
Time to Address
Emotional
Behavioral
Family
School/work
Friends/peers
Delinquency
Alcohol/Substance use
Harm to self/others
Client hope
Client motivation for treatment
TA with client
Client impact
Client service satisfaction
Caregiver strain
Caregiver life satisfaction
Caregiver motivation for treatment
TA with caregiver
Caregiver service satisfaction
Percentage of clinicians addressing patient feedback topics over time (in weeks)
no feedback
with feedback
In other words, the duration to event is shorter
For example, at 20 weeks the survival rate is 0.25 for the feedback group and 0.35 for the non-feedback group, which means that behavioral issues have been addressed/focused on for 75% of clients in the feedback group compared to 65% of clients in the non-feedback group
For the 2 exceptions (problems with delinquent behavior and alcohol/substance use) where feedback did not shorten time to addressing content, both were typically addressed infrequently with the first occurrence after several weeks in treatment
(Douglas et al., 2016)