What Measurement-Based Care Is
Measurement-based care (MBC) means collecting standardised clinical outcome data from patients/clients at regular intervals throughout their treatment, sharing that data with both the clinician and the client, and using the data to make clinical decisions - including whether the treatment approach should change.
In practice at Refill Health: PHQ-9 and GAD-7 are completed by the employee every two sessions. The therapist receives the updated scores before the session starts. If scores are not improving after 4-6 sessions, the case is reviewed by Refill Health's clinical supervisor and a change may be recommended - a different modality, a different therapist, or a referral for psychiatric assessment.
This is meaningfully different from the standard therapy model, where progress is assessed by therapist impression and client self-report without systematic quantification. MBC doesn't replace clinical judgement - it makes it more informed.
What This Means for Your Procurement Decision
When evaluating any mental health programme, ask this single question: "Can you show me the average PHQ-9 score change from programme entry to programme exit across your active clients?" If the answer is "we don't collect that data," you are looking at a programme without measurement-based care. If the answer is a specific number (Refill Health's 2025 figure was -4.8 points average), the programme is measuring outcomes. The number itself tells you the magnitude of clinical improvement. The fact that a number exists tells you the programme is running on clinical evidence, not activity metrics.
Why MBC Produces Better Outcomes
A 2016 meta-analysis by Shimokawa, Lambert, and Smart (covering 6,000+ clients across 12 studies) found that therapists who received regular feedback on client progress through a measurement tool produced significantly better outcomes than therapists working without it. The effect was largest for clients who were at risk of deterioration - MBC essentially creates an early-warning system that prevents the most common cause of poor therapy outcomes: continuing a treatment that isn't working.
The key finding for HR leaders: An EAP that does not measure outcomes cannot tell you whether it is working. An EAP with measurement-based care can show you, with specific before-and-after clinical data, whether employees are improving. This is the difference between a programme that generates activity reports (sessions booked, calls answered) and a programme that generates outcome reports (clinical symptom reduction, functional improvement). The former tells you the programme is being used. The latter tells you it is working.