It’s been 6 years since the launch of our coordinated Measurement-Based Care (MBC) implementation in partnership with the Community Behavioral Health Association of Maryland (MDCBH). Designed as a statewide effort, this initiative brings together community-based behavioral health organizations under a collaborative approach to implementing MBC, empowering members to align on common tools, workflows, and best practices to drive consistency and impact across care settings.
The collaborative combines consistent outcome measurement, meaningful client engagement, and real-time data to improve clinical decision-making at scale. Early results from the initial 1 year pilot, launched in 2020, demonstrated strong clinician adoption, high client engagement, and meaningful improvements in therapeutic alliance, validating the intention behind a coordinated MBC implementation across any region, state, or association.
Since the pilot, the initiative continued to evolve into a statewide model for delivering more consistent, data-informed behavioral health care across Maryland. The results speak for themselves:
The Results
The coordinated pilot started with 16 clinics, including 690 clinicians, serving over 9800 clients across Maryland. Now, in 2026, the MBC implementation includes over 709 clinicians, 30 organizations, and more than 15000 clients in care.
- 206,424 Assessments Completed
- 85% Average Therapeutic Alliance
- 39% Average Symptom Improvement
- 41% GAD-7 (Anxiety) Recovery Rate
- 55% PHQ-9 (Depression) Recovery Rate
These metrics signal a fundamental shift in how care is being delivered across Maryland today. With an average of 6.8 assessments per active client, measurement is no longer an occasional touchpoint, but rather a consistent part of the care journey.
MBC is most effective when it’s integrated as part of an ongoing feedback loop, enabling clinicians and clients to track progress, identify when care is off track, and make timely adjustments to treatment plans. By systematically capturing client-reported outcomes and integrating them into clinical conversations, providers are better equipped to deliver personalized, responsive care that leads to meaningful improvement.
These outcomes demonstrate MDCBH’s commitment to embedding MBC into routine care, informing how care is delivered through personalized, evidence-informed insights.
The most commonly used measures include:
- PHQ-9 (Depression)
- PSC-17 (Pediatric Symptoms)
- GAD-7 (Generalized Anxiety)
- TASC (Therapeutic Alliance for Youth and Caregivers)
- BR-WAI (Therapeutic Alliance)
“Greenspace is a highly effective, user-friendly solution for Measurement Based Care. It streamlines MBC implementation, providing visible progress and fostering client engagement, while also significantly reducing administrative burden for providers and enhancing overall operational efficiency.” said Valerie Darbonnier, Greenspace Coordinator, Behavioral Health Division at Calvert County Health Department.
Scaling From a Pilot Program to Statewide Adoption
Greenspace worked with MDCBH to develop a coordinated, system-wide approach to implementation. Rather than leaving organizations to adopt MBC independently, the initiative established shared infrastructure, standardized practices, and centralized reporting. This has enabled:
- Greater visibility into outcomes across the state
- Data-informed decision-making at both clinical and system levels
- Stronger alignment between providers, funders, and policymakers
As highlighted in earlier phases of the initiative, this coordinated approach helps overcome common barriers to MBC adoption, such as administrative burden, lack of analytics resources, and inconsistent client engagement.
The most valuable thing about participating in the coordinated implementation of MBC for us, as an outpatient mental health clinic, was the open space for questions and consulting it offered. Starting to change how we use measures to guide our treatment felt like a daunting task, and though we were excited to start, there were aspects we were unsure of. The coordinated implementation offered a community of practitioners that provided excellent feedback, support and an open forum for learning and questions.
Looking Ahead: The Future of Behavioral Health
Six years in, Maryland’s MDCBH initiative stands as a leading example of how Measurement-Based Care can transform behavioral health systems at scale.
By embedding data into every level of care, from individual sessions to system-wide planning, the initiative is not only improving outcomes today, but also building a foundation for more accountable, equitable, and value-driven care in the future.
As more regions look to implement MBC, Maryland offers a clear blueprint; when providers align around shared measurement, leverage real-time data, and commit to continuous improvement, the result is better care at every step of the care journey.
Interested in learning more about implementing MBC? Schedule a call with an implementation specialist or reach out anytime at info@greenspacehealth.com
