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In order to best serve high-acuity patients—including those suffering from a serious mental illness (SMI)—those in the healthcare ecosystem must evolve how we think about and measure standards of care. 

Valera Health is a leading telemental healthcare practice known for its high-quality, accessible and innovative care. We take a comprehensive and team-based approach that includes therapists, psychiatrists, nurse practitioners and physicians working closely together to provide holistic care for our patients. At the cornerstone of this approach is measurable quality. 

From practicing internal medicine to leading and advising healthcare organizations, I’ve seen firsthand how critical quality measurement is when it comes to informing care practices and optimizing patient outcomes. This is especially true when it comes to high-acuity patients. 

In order to best serve high-acuity patients—including those suffering from a serious mental illness (SMI)—those in the healthcare ecosystem must evolve how we think about and measure standards of care. 

While performance measurement standards included in the Healthcare Effectiveness Data and Information Set (HEDIS) remain a gold standard measure of value and diagnostic measurements such as PHQ-9 and GAD-7 can be highly effective tools for measuring depression and anxiety outcomes, we miss critical insights into effectiveness of care for SMI and high-acuity patients when using these quality measures alone. More complex disorders require a unique assessment strategy. 

Recently, the Centers for Medicare & Medicaid Services (CMS) updated its  “Universal Foundation” in order to streamline quality measures and programs for the adult and pediatric populations it serves. An important CMS topic of discussion is measuring patient-centric care through patient-defined care goals (a.k.a. self-determined goals). This can be particularly challenging for high-acuity patients. 

At the heart of everything we do at Valera Health is a patient-centric approach to clinical care and quality measurement. After all, no two individuals are the same—nor are their behavioral healthcare needs. 

As a pioneer of utilizing virtual care to treat SMI and high-acuity populations, Valera Health has always embraced data-backed strategies in order to optimize patient experiences and outcomes, clinical processes, and system changes. 

With this in mind, I’m excited to announce an important advancement in Valera Health’s quality measurement standards.

In 2024, Valera Health will incorporate World Health Organization Disability Assessment 2.0 (WHODAS 2.0) into our clinical model for SMI patients. A globally verified quality measurement standard, this clinical assessment meets current CMS selection criteria1 and furthers our patient-centric approach. 

Moreover, this assessment is applicable to broader categories of disability and functioning beyond just mental health. Thus, it enables a deeper understanding of the impact of severe mental illness on other chronic or comorbid conditions.

When measuring clinical outcomes for underserved populations, implementing universal, comprehensive, and clinically validated assessments takes on a new importance. WHODAS 2.0. applicability cross-culturally in both clinical and general population settings and its versatility—the assessment is designed to be used across all mental, neurological and addictive disorders—made it appropriate for the diverse range of populations we serve. 

Additionally, the assessment is short and can be both self-administered or administered by a clinical professional, which removes tech-literacy barriers and aids in ease of use. 

This assessment is likely to provide additional actionable insights to clinicians and care teams by sharing which aspects of a patient’s daily activities are impacted the most by their condition. These measures are especially pertinent for improving treatment outcomes for SMI and high acuity patients, as difficulty with daily functioning is a hallmark of these conditions. 

As we move forward, Valera Health remains steadfast in its commitment to continually setting new standards in mental health quality through patient-focused care. Integrating the WHODAS 2.0 advances our clinical model by helping us better address the needs of the highest acuity patients rather than over-relying on assessments–such as PHQ9 and GAD7–that are designed for depression and anxiety but are often used as proxies for overall mental health. 

Valera Health’s mission is to provide compassionate mental healthcare to those who need it the most, when they need it the most. Doing so requires continually evolving our care model so care teams have detailed insight into their patients’ functioning, and can deliver personalized, effective treatment tailored to their unique needs and challenges.

For more information, please contact our director of Business Development, Cassie Dawalt, at

1 Additional Universal Foundation Selection Criteria Include:

  • The measure is of a high national impact
  • The measure can be benchmarked nationally and globally
  • The measure is applicable to multiple populations and settings
  • The measure is appropriate for stratification to identify disparity gaps
  • The measure has scientific acceptability
  • The measure is feasible and computable (or capable of becoming digital)
  • The measure has no unintended consequences