value based care

Establishing “Payviders” in Behavioral Health

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One growing trend in the business side of healthcare has been the combination of payer organizations and healthcare providers to create entities known as “payviders.”  The idea of a payvider first originated in the 1990s. Some longstanding examples of payviders include California-based Kaiser Permanente or Pennsylvania-based Geisinger Health System. Other payviders have emerged in recent … Read more

State Reporting for Behavioral Health: Deciphering the Alphabet Soup

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If your behavioral health agency is using an electronic health record (EHR) system to measure outcomes and report data, you know that there are numerous reporting techniques.

Payers like Medicare, Medicaid, and private insurers use these reporting techniques to measure client outcomes. This allows the payer either to provide bonus payments under incentive programs, or withhold payments for undesirable outcomes. In this way, healthcare systems are migrating from fee-for-service (FFS) to value-based payment (VBP) models.

Different reimbursement programs require different types of reporting. Unfortunately, the “alphabet soup” of acronyms for different reporting methods can be confusing and overwhelming. Let’s decipher some of these reporting types.

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The Importance of Value-Based Care in Behavioral Health

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As the healthcare field evolves into a more efficient system, key changes allow for advances that are revolutionizing the industry. An innovative new value-based care model has expanded the focus to reducing costs, decreasing medical errors, and achieving better overall health for clients. Providers are increasingly turning to this value-based healthcare model in order to achieve value-based results. 

Under this model, providers are rewarded for helping individuals reduce the negative impact chronic disease can have on a client’s life and the number of occurrences of chronic diseases. Rather than being paid by each service they prescribe or perform, they are rewarded based on the health of the client.

A value-based model can: 

  • Lower costs for clients
  • Increase client satisfaction
  • Offer reduced health risks
  • Align prices with outcomes 
  • Lead to better overall health 

This model is spreading through the primary care industry and while it’s had a positive impact, the behavioral health industry has been slower to adopt it.

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The Value of Data in a Value-Based Market

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Many behavioral health organizations are required to deliver data to outside funders, to track performance and client health. This is part of a health model called “value-based healthcare.” But if organizations are only collecting this information to satisfy funders, it can seem like a tedious and overwhelming process. Understanding the true significance of data in a value-based healthcare market can help healthcare providers actively utilize this information to improve the quality of care.

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