MBC Education  |   Apr 15, 2025  |   2 minute read

New Standards for CARF Accreditation: The Impact of Measurement-Based Care

New Standards for CARF Accreditation: The Impact of Measurement-Based Care
  1. CARF’s Requirements for Measurement-Informed Care (MIC / MBC)
  2. Testimonials from CARF-Accredited Organizations
  3. Achieving CARF Accreditation with Greenspace Measurement-Based Care

The Commission on Accreditation of Rehabilitation Facilities (CARF) recently released its 2025 Behavioral Health Standards Manual, which introduces a new requirement for organizations to incorporate a procedure for Measurement-Informed Care (MIC)—also commonly known as Measurement-Based Care (MBC). While the terminology used across the industry may vary, both MIC and MBC are used interchangeably to describe the clinical practice of using standardized assessments to routinely track a person’s symptoms and progress throughout care. The outcome data is then used to inform clinical decision-making and foster collaborative discussions between providers and their clients.

To understand the importance of CARF’s updated accreditation requirements, let’s explore what they involve, how they impact clinical care, and how organizations can leverage Greenspace to enhance treatment outcomes and meaningfully improve care quality.

CARF’s Requirements for Measurement-Informed Care (MIC / MBC)

Standard 2.A.12, newly introduced in CARF’s 2025 Behavioral Health Standards Manual, requires organizations to develop a clear, written procedure for implementing MIC / MBC. This procedure must address the following key components:

  1. Identify the tools to be used: Organizations must select and clearly define the standardized assessment tools that will be used to meet the needs, goals, cultural and linguistic backgrounds, and reading levels of the individuals they support. Common examples of behavioral health assessment tools include, but are not limited to, the PHQ-9, GAD-7, DAST-10, and BR-WAI. When used consistently throughout care, these measures help monitor client symptoms over time, inform meaningful clinical discussions and treatment decisions, and ensure that care plans remain focused on the evolving goals, needs, and experiences of those being treated. To explore other evidence-based assessment tools, you can visit our Assessment Hub.
  2. Prescribe intervals for administration of the tools: Organizations must set clear guidelines for how frequently assessment tools are administered, tailored to each individual’s condition and needs. Common intervals can include a baseline assessment before starting treatment, regular monitoring at specified intervals during treatment (Greenspace recommends assessments be assigned every two weeks, but individual measures will often have recommendations that have been validated by the authors), and as-needed assessments at critical transition points or when there are additional concerns about a person’s condition.
  3. Outline how results will be shared with individuals in care: A core aspect of MIC / MBC is sharing assessment results with the individuals receiving care. Regularly reviewing results and discussing symptom changes helps clients understand the value of the measurement process on their care quality. Sharing results with clients also helps to enhance client engagement throughout care, increase treatment adherence, and improve clinical outcomes. CARF requires organizations to have a defined process for sharing assessment results with clients to increase transparency, accountability, and strengthen therapeutic alliance.
  4. Identify personnel training required: To support effective implementation, organizations must provide comprehensive training for clinical staff. This includes sharing the rationale for using MIC / MBC, guidance on administering and scoring assessment tools, and strategies to interpret and respond to results. When clinicians are well-informed on the benefits of MIC / MBC and genuinely engaged, they’re well-positioned to inspire the same level of curiosity and participation in their clients. That’s why it’s essential to support them with ongoing training, practical tools, supportive resources, and strong leadership support throughout implementation and day to day practice.

Greenspace has supported numerous CARF-accredited organizations, playing a distinct role in helping them meet and maintain accreditation standards. Our MBC platform provides a seamless experience and purpose-built solution for organizations committed to delivering high-quality care aligned with CARF’s behavioral health standards for progress outcome measurement.

Lisa Russell
Brandon Fisher, Chief Strategy Officer, Merakey

"MBC became one of our highest priority strategic initiatives because we believe we can empower people in care to better understand their mental health, be active participants in the care process, and better communicate their needs and experiences with their provider, which leads to improved services and outcomes."

Jim Spencer, Senior Director of Clinical Management, NBHCC

“The strength of our MBC pilot lies in our collaborative efforts to measure and enhance clinical outcomes for our members. With the combined expertise of Greenspace, local clinicians, behavioral health agencies, county administrators, managed care, researchers and academic institutions, we are collectively designing a new powerful initiative for our region.”

Lisa Russell, Chief Program Officer, Encompass Community Services

“By partnering with Greenspace, we are able to improve client-provider communication and inform treatment decisions, which is a real game-changer to help us improve overall outcomes and equity in care.”

Rob D’Alonzo, LPC, Chief Clinical Officer, The Lincoln Center for Family and Youth

"Greenspace allows us the flexibility to easily capture baselines, but more importantly track progress over time. It is so empowering to be able to clearly identify the impact we are having across the students, and also identify those that may need additional support. Our team has found the dashboards to be relevant to track engagement and clinical outcomes, and while it isn't our first time measuring students' baselines, we are hopeful that our clinicians can use the insights and develop more streamlined treatment plans."

Achieving CARF Accreditation with Greenspace Measurement-Based Care

Here’s how Greenspace can support your organization in easily implementing each of the CARF requirements outlined above:

  1. Tools: Greenspace has over 400 evidence-based assessments available on our platform, with the flexibility to customize the measures used based on an individual’s presenting issues and symptoms, as well as the ability to add any additional assessments. Clients can complete assessments remotely and in person through a multilingual, user friendly platform. Our client-facing dashboard allows clients to complete assessments and and reflect on their results in their preferred language. With over 3 million assessments completed to date, our clinical partners have achieved an average symptom improvement score of 49%.
  2. Assessment Frequency: Tailor the frequency of assessment delivery based on client needs or program requirements and goals. Clients can complete assessments at home via email or SMS, or in-person through our Kiosk tool before, during, or after sessions. Remote assessment settings, including frequency and timing, are fully configurable to align with your clients preferred delivery methods and schedule. Providers can adjust assessment frequency or add new measures throughout care based on clinical needs, ensuring flexibility as treatment evolves.
  3. Communicate Results: Client visibility is a core pillar of MIC / MBC, which means providing clients with access to their results, allowing them to better understand their symptoms and progress and empowering them to take a more active role in their care process. This transparency supports more meaningful clinical conversations and collaborative decision-making. Evidence shows that empowering clients with visibility into their own results has a significant impact on results. Particularly with clients considered not-on-track, one study found that clients receiving regular feedback on their results saw twice the rate of clinically significant change (23% vs. 10%) compared to those who did not (Hawkins et al., 2004). Learn more about the impact of client visibility here.
  4. Training and Implementation: With over a decade of experience, we’ve refined our approach to provide comprehensive support and ensure a smooth, effective implementation of MBC across your team—encompassing everything from service flow and assessment selection to clinician training and resources for client education and engagement. Having partnered with over 500 behavioral health organizations—ranging from small clinics, to large community clinics, hospitals and full health systems—we’ve successfully supported MBC implementations across the full ecosystem of behavioral health services. Our dedicated Customer Success team and implementation experts are on hand to help you get started and support the development of an implementation plan that aligns with your clinical needs and meets CARF requirements.

MBC / MIC has been recognized as a core component of delivering high-quality, evidence-based behavioral health services by CARF and other accrediting bodies, including the Joint Commission. Its value lies in equipping clinicians with real-time data and insights to inform care decisions, track symptom changes, and tailor treatment based on each individual’s needs, ultimately driving meaningful improvements in clinical outcomes. We understand that implementing MBC can be complex, which is why we partner with organizations across North America to provide the technology, tools, and expertise that make MBC intuitive and effective, while fitting naturally into your team’s existing workflows.

 

Upcoming Virtual Panel Session

To learn about the essential role of MBC within CARF accreditation, implementation strategies, and clinical best practices, join our upcoming virtual panel, ‘Measurement-Based Care & CARF Accreditation: Driving Quality Through Measurable Outcomes‘, on May 15th at 1PM EDT.

Register Now

If you’re interested in learning more about implementing MBC to meet accreditation standards and improve treatment outcomes, schedule a call anytime with an expert or reach out anytime at info@greenspacehealth.com.

Frequently Asked Questions
What is the difference between Measurement-Based Care (MBC) and Measurement-Informed Care (MIC)?

There is no real difference. MBC and MIC are terms that are often used interchangeably. While the naming conventions vary slightly, both refer to the same evidence-based process.

At their core, both MBC and MIC involve the systematic collection and use of standardized measurement tools (like patient-reported outcome measures, or PROMs) throughout care to inform and improve the quality of mental health treatment.

Both MBC and MIC emphasize the consistent collection and integration of outcome measurements (collected through PROMS, clinical interviews, or physiological assessments) to inform care decisions and treatment planning. There is a particular emphasis on using outcome data collaboratively: involving the client in goal-setting, treatment decisions, and ongoing discussions about their progress. In this way, outcome data acts as a clinically valuable tool for shared decision-making and deeper client engagement, not just clinical evaluation.

While some suggest that MBC is less focused on the collaborative use of data to inform care decisions, this isn’t the case. Most experts, including our partners at the Yale Measurement-Based Care Collaborative (YMBCC), emphasize the collaborative nature of MBC. The YMBCC uses ‘Collect, Share, Act’ to define this process, highlighting the importance of sharing results with clients to spark conversation, encourage reflection, and inform treatment decisions. At Greenspace, we often refer to the ‘4 C’s of MBC’, where Collaboration is a foundational component of any effective MBC implementation.

To summarize, both MBC and MIC aim to enhance mental healthcare by collecting standardized outcome data and using it throughout care in a collaborative, client-centered way. Regardless of which term your team prefers, what matters most is implementing an approach that empowers clients, centers their voice in care, and leads to better engagement and outcomes.

What are the benefits of Measurement-Based Care?

There are many benefits of Measurement-Based Care, supported by research and proven across most types of behavioral health service settings. We’ve listed four of the most widely applicable benefits below, though there are many others. If you’re interested in exploring how MBC can support your organizations clinical goals, reach out anytime.

  • Enhanced client care: Measurement-Based Care is proven to increase engagement, enhance therapeutic alliance, reduce drop-out rates and no-shows, and improve treatment outcomes for people in care.
  • Objective data-informed care: By consistently capturing objective clinical insights throughout care, clinicians can monitor treatment progress, proactively identify and address off-track clients, and enhance clinical decision-making.
  • More equitable care: Measurement-Based Care helps level the playing field in treatment, by ensuring that clients are empowered as partners in their care process and can better understand and communicate their needs and experiences throughout—regardless of their background, education, or past experience with mental health services.
  • Continuous service improvement: Measurement-Based Care helps to foster a culture of learning and improvement among clinical teams. It enables teams to collaborate, share insights, and identify what works across different populations and conditions while also helping organizations demonstrate impact and focus on quality improvement where it’s most needed.
What is the purpose of Accreditation?

Accreditation indicates that an organization meets established standards of care and service quality, in order to provide the best possible outcomes for clients. For behavioral health organizations, CARF accreditation offers a framework for continuous improvement and accountability that ensures services are effective, evidence-based, and aligned with international best practices.

By achieving CARF accreditation, organizations demonstrate their commitment to providing high-quality, client-centered care that meets industry standards. By demonstrating this dedication to improving outcomes and achieving excellence, accreditation fosters trust with clients, clinicians, and stakeholders.

What is the difference between CARF and The Joint Commission?

While both the CARF and The Joint Commission are respected accrediting bodies focused on ensuring high standards of care, they have different areas of focus.

The Joint Commission accredits a broad range of healthcare organizations, including behavioral health, with an emphasis on overall quality, patient safety, and compliance with healthcare regulations.

CARF is more specifically focused on rehabilitation and behavioral health services, with internationally-recognized accreditation standards designed to ensure that organizations provide client-centered care.

MBC is recognized as a foundational component of delivering high-quality, evidence-based behavioral healthcare services by both the CARF and The Joint Commission.

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