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Blue Cross NC, Quartet roll out value-based payment model for behavioral health

As the U.S. healthcare landscape moves from fee-for-service to value-based payment (VBP) models, value-based care has been difficult to implement for behavioral health and addiction treatment. A new model from Blue Cross and Blue Shield of North Carolina, however, could help encourage broader VBP adoption in behavioral health.

Blue Cross NC’s New Model

Blue Cross NC is collaborating with New York City-based startup Quartet in its launch of a VBP model for behavioral healthcare. This model, called Blue Premier Behavioral Health, will give behavioral health providers incentive payments for certain improvements and for meeting benchmarks in quality measures. This partnership is also meant to encourage cooperation between providers and improved patient outcomes.

Under the collaboration, launched January 1, 2020, Blue Cross NC and Quartet will combine assets to measure clients’ quality of care. Eligible providers will be able to use Quartet’s technology to collect data and measure quality outcomes, while supporting improved patient care.

This plan also integrates with Blue Cross NC’s value-based program, Blue Premier. Under this care program, both providers and Blue Cross NC are accountable for improving patient care and reducing costs.

According to Blue Cross NC’s official announcement, the new Blue Premier Behavioral Health builds on the company’s efforts, started in 2019, to better integrate behavioral and physical health care. Last year, the payer began to offer Quartet’s services for free to both primary care and mental health providers.

With Quartet’s technology, providers can refer patients to appropriate behavioral health providers. It also allows providers to collaborate for the care and support their patients need.

The new Blue Premier Behavioral Health could help provide better access to high-quality, coordinated care for behavioral health and addiction treatment clients. Because this change is so revolutionary, it could serve as an example for other health plans looking to adopt VBP models for behavioral health.

Challenges for VBP in Behavioral Health

As primary care providers struggle to address their patients’ mental health and substance misuse needs, physical and mental health integration becomes increasingly necessary. Despite the increased need for better behavioral health integration, however, there are still significant disparities between access to behavioral health services compared to physical health services.

A 2019 report from Milliman, Inc. found that inpatient, out-of-network use of behavioral health services was five times more likely than for medical/surgical services, an increasing gap compared to 2013. The report also found that office visit disparities between behavioral and physical health were five times higher in 2013 and increased to 5.4 times in 2017.

By establishing a VBP model for behavioral health, Blue Cross NC’s example may help close the gap between physical and behavioral health coverage, while also improving patient outcomes and lowering costs.

Prepare Your Practice for Value Based Care

The right EHR system is vital for behavioral health and addiction treatment providers looking to record and track patient data and outcomes under value-based care. Enter and track patient information accurately with BestNotes, a behavioral health EHR solution built specifically for your practice’s needs. Contact us today to learn more, or schedule a live demo.

date:  Feb 11, 2020
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Florida Behavioral Health and Addiction Treatment News Roundup for February 2020

This week’s post is taking a look at the behavioral health and substance misuse issues making headlines in Florida.

Central Florida Students to Receive Mental Health Lessons

Several schools in Central Florida are rolling out a new plan to require five hours of mental-health lessons for students in grades 6-12. This plan was partly inspired by the 2018 shooting at Parkland high school.

Starting in January or February 2020, the lessons will include topics such as substance abuse and suicide prevention. This initiative, which was approved by the State Board of Education in July 2019, could help reduce stigma and provide education to families.

PrimaHealth Credit to Offer Loans for Addiction Treatment

PrimaHealth Credit is expanding its services to include loans used to pay for addiction treatment centers. The company currently provides loans for elective healthcare procedures like plastic surgery and orthodontics. Florida is one of several locations where PrimaHealth is offering these addiction treatment loans.

Many individual borrowers will not be charged interest for addiction treatment loans. In those cases, PrimaHealth will charge a fee to the treatment center. PrimaHealth’s algorithm helps determine a borrower’s creditworthiness and offers treatment centers a payment management solution. PrimaHealth has also said that it intends to help addiction treatment providers meet regulatory requirements for collecting co-pays and deductibles.

Florida Sees Rise in Meth-Related Deaths

According to a 2019 report by the Florida Department of Law Enforcement and the Medical Examiners Commission, the rate of meth-related deaths in the state have increased, based on instances when methamphetamines were found in a person’s system upon their death. Occurrences of methamphetamine increased 9 percent in January-June 2018, compared to the same period in 2017, while deaths caused by meth rose 24 percent.

The report also found that, in the same periods, the rate of opioid-caused fatalities decreased. However, deaths caused by fentanyl increased in the same period.

CDC Underestimates Florida Drug Overdose Fatalities, Study Finds

Study data suggest that the CDC’s Multiple Cause of Death (MCOD) database underestimates drug overdose fatalities in Florida. Troy C. Quast, PhD, of the University of South Florida College of Public Health, compiled the number of overdose deaths listed in the MCOD database for Florida involving amphetamines, benzodiazepines, and opioids in 2003-2017. Compared to the numbers reported by the Florida Medical Examiners Commission, the MCOD undercounted benzodiazepine-related deaths by 45 percent and amphetamines-related deaths by 17 percent.

Florida’s Flagler County Looking to Establish Drop-In Mental Health Clinic

Flagler County, Fla., is considering an effort to address local mental-health concerns by establishing what is being called a “drop-in mental health clinic.” According to Flagler County Administrator Jerry Cameron, the clinic would operate like many other clinics that offer physical health services without requiring an appointment. Cameron noted that such a clinic would come from a private/public partnership between the county and area providers.

Streamline Your Behavioral Health and Addiction Treatment Practice in Florida

The demand for behavioral health and addiction treatment services continues to rise in Florida and across the nation. As you work to meet your clients’ needs and streamline your practice, it’s important to have an EHR solution that helps, not hinders, your efforts. Contact the team at BestNotes today to learn more about how our EHR and CRM solutions can help you operate an effective, profitable behavioral health practice.

date:  Feb 03, 2020
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Why and How to Follow Up on Behavioral Health Discharges

Patients who have been hospitalized for a behavioral health incident, such as a substance overdose or a psychiatric episode, are highly vulnerable in the first few weeks or months after discharge. Behavioral health and addiction treatment can be frightening and isolating for many clients, especially after hospitalization or other inpatient stay.

During this period, your behavioral health client is at increased risk of relapse and even suicide. Therefore, it is critical for behavioral health practices to establish a follow-up plan for each client after discharge.

The Importance of Follow Up

Follow-up care is strongly recommended for addiction treatment and other behavioral health incidents. Research shows that 40 percent to 60 percent of individuals who are recovering from drug or alcohol addiction relapse. Long-term follow-up care is one method that has helped reduce relapse risk.

Appropriate follow up after discharge is also important for clients who are at risk of suicidal behavior. Research shows that 26 percent of all suicidal acts happened within the first month after discharge, and more than 40 percent within the first three months.

Research also indicates that when follow-up treatment is poorly integrated into a client’s psychiatric care, it could lead to lower-quality treatment, and thus worse outcomes.

Caring Letters in Follow Up

In the late 1960s and early 1970s, researchers working with psychiatrist Dr. Jerry Motto, of the University of California, San Francisco, sent “caring letters” to individuals who had been hospitalized for suicide and depression. These discharged patients had refused follow-up care.

The caring letters included simple notes expressing interest and concern. The letters did not demand a response, such as making a follow-up appointment, but did invite recipients to reply, if desired.

In the first two years after hospital discharge, the average suicide rate of the “caring letter” recipients was about half of those who did not receive a letter. These letters may have helped the recipients feel more connected to others just by letting them know that someone cared.

Creating a Follow Up Protocol

Behavioral health organizations and providers can integrate follow up in numerous ways, ranging from the simple to the complex. These include:

Notes and caring letters
Phone calls
Home visits
Text messages

The chosen methods should be integrated into an overall, structured, consistent follow-up protocol, according to the National Suicide Prevention Lifeline. Behavioral health providers should obtain client consent for follow-up early in their care and make sure that each client understands the follow-up service.

Discharge follow-up plans should include:

Thorough documentation, including all suicide risk assessments, management plans, consultations, and all actions that occurred as part of follow-up, including any caring letters, texts, phone calls, or home visits
Information from admitting facilities
Assessing for continued suicide or relapse risk
Focusing on medication adherence, if applicable
Culturally appropriate interventions to help reduce outcome disparities among racial minority groups

BestNotes EHR solutions allow users to save form letters for follow-ups, as well as send questionnaires for progress monitoring. This not only helps you reach out to individual clients, but can also help improve client outcomes, and better track data for reporting.

The right EHR system is vital for accurate documentation and thorough follow-up of behavioral health and addiction treatment discharges. Contact BestNotes today to learn more about our customizable options.

date:  Jan 28, 2020
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What is Acceptance and Commitment Therapy and How Does it Work?

Acceptance and commitment therapy (ACT) is a type of counseling and psychological intervention that combines acceptance and mindfulness strategies with commitment and behavior-change strategies. Previously known as comprehensive distancing, it was developed in 1982 by Steven C. Hayes to combine cognitive and behavioral therapy.

How is ACT used?

ACT is intended to help clients increase their psychological flexibility. Psychological flexibility is usually defined as a person’s ability to stay in contact with the present moment and choose behaviors appropriate to their situation and values, even while experiencing unpleasant thoughts or feelings. This is an important part of developing resilience.

ACT clients can learn to accept their deeper feelings as appropriate responses to certain situations, without allowing them to prevent progress in life. Clients can learn to accept their difficulties and commit to making necessary behavioral changes, whatever may be happening in their lives or how they feel.

What does ACT involve?

With ACT, a client does not try to control, avoid, or feel guilty about painful emotions and past experiences. Instead, ACT encourages the client to embrace, learn from, and accept their thoughts and feelings while working to change behavior.

There are six core processes involved in ACT:

Cognitive Defusion: The client learns to recognize and accept their thoughts and feelings as “just thoughts,” without getting caught up in them or giving them control.
Acceptance: The client learns to embrace difficult experiences or feelings, such as anxiety or pain, and to let them pass by without avoiding or struggling with them.
Contact with the present moment: Through practices such as mindfulness, the client develops awareness, openness, interest, and receptiveness to the here and now.
The Observing Self: The client develops a transcendent sense of self, recognizing that their thoughts, feelings, memories, and physical body are constantly changing, and are not the essence of who they are.
Values: The client identifies and clarifies what is most important to them and who they want to be.
Committed action: The client sets goals based on their values and works toward them responsibly and meaningfully.

With ACT, the therapist works with the client on their self-talk and helps the client determine what issues require immediate action or change, and what can be accepted as-is. The therapist guides the client to stop fighting his or her emotions and past experiences, and instead practice more helpful behaviors to achieve personal goals.

Does ACT work?

ACT has been used to treat or manage a variety of behavioral health concerns, as well as manage physical conditions such as chronic pain and diabetes. Uses for ACT include:

Workplace stress
Test anxiety
Social anxiety disorder
Obsessive-compulsive disorder
Substance abuse

The research into ACT is still somewhat limited, but evidence suggests that ACT is superior to placebo for treating several concerns. Other research suggests that ACT may be equal to established interventions in treating anxiety disorders, depression, addiction, and somatic health problems.

Like most behavioral health treatment approaches, ACT is highly adaptable to different providers, clients, and settings. Shouldn’t your EHR solution be just as flexible? BestNotes offers EHR solutions that can be customized to your practice’s unique needs to help you save time, reduce frustration, improve profitability, and meet state reporting requirements. Contact us today to learn more or schedule a demo.

date:  Jan 24, 2020
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Looking Forward to Value-Based Care in 2020

Value-based payment (VBP) models and value-based care have been difficult to implement, and behavioral health in particular has been slow to adopt VBP models. However, this year saw significant changes toward the implementation of VBP that providers should know about.

Key payers and providers, including the Centers for Medicare and Medicaid Services (CMS), announced in late 2018 that 48 percent of their business was finally tied to VBP models, according to Forbes. The Health Care Transformation Task Force is aiming for 75 percent of their respective businesses operating under VBP models by the end of 2020.

With that in mind, behavioral health and addiction treatment providers should be aware of significant developments in value-based care, and prepare for additional changes.

Value-Based Care Affects Healthcare Business and Financial Practices

The move to VBP has driven providers and healthcare organizations to rethink how they do business, operate efficiently, and control costs. As a result, the last few years have seen a rapid increase in healthcare mergers and acquisitions. Additionally, providers and health systems have been partnering with behavioral health organizations to expand their behavioral health or addiction treatment offerings in a cost-effective way.

In transitioning to VBP, providers are also rethinking how they work with payers. VBP models require payers and providers to agree on how much reimbursement is needed. Payers are encouraged to help providers choose the best care approach, while providers are encouraged to stay within their financial limits, while both sides work to reduce risk.

New Technology Will Influence Move to Value Based Care

As VBP encourages increased accuracy and healthcare savings, developers are demonstrating new technologies to help track health data. This includes digital therapeutics, a subset of digital health that leverages sophisticated software programs to help manage health conditions based on evidence-based interventions. Digital therapeutics could help patients with chronic conditions, including behavioral health concerns, follow treatment plans while supplying providers with more helpful data to guide those treatment plans.

Value Based Care Could Accelerate Under New Leadership

New leadership may also be key in encouraging the move to VBP models. This month, the Trump Administration chose Brad Smith to direct the Center for Medicare and Medicaid Innovation (CMMI). This agency was created by the Affordable Care Act and is tasked with testing and implementing healthcare payment and service models, especially those with a VBP focus.

Smith is former COO of insurance giant Anthem’s Diversified Business Group, and the co-founder and CEO of palliative care services company Aspire Health. In his new role, Smith will also be a senior advisor for value-based transformation to Department of Health and Human Services Secretary Alex Azar. Colleagues have noted that his experience in healthcare and entrepreneurship could help further the implementation of VBP models.

Prepare Your Practice for Value Based Care

The right EHR system is vital for behavioral health and addiction treatment providers looking to record and track patient data. Enter and track patient information accurately with BestNotes, a behavioral health EHR solution built specifically for your practice’s needs. Contact us today to learn more, or schedule a live demo.

date:  Jan 16, 2020
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