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State Efforts to Expand Value Based Payments to Behavioral Health

As we’ve discussed before on the BestNotes blog, value-based care is becoming the future of U.S. healthcare. However, most value-based payment (VBP) models have focused on physical health rather than behavioral health.

The law firm of Manatt, Phelps & Phillips, LLP, under its Manatt Health division, recently created a report for the California Health Care Foundation that examines how three state Medicaid programs have adopted VBP models for behavioral health.

While this report is focused on California-specific recommendations, it provides valuable information for any state looking to implement VBP for behavioral healthcare.

What the Report Includes

The Manatt Health report focuses on three state Medicaid programs:

Vermont: The state Medicaid program implemented a hub-and-spoke model that expanded addiction treatment access. Also, its Mental Health Payment Reform Residential Substance Use Disorder Case Rate and Applied Behavioral Analysis Case Rate methodologies may further expand behavioral health VBP.

New York: The state’s Behavioral Health VBP Readiness Program helps behavioral health providers create networks that can participate in VBP models.

Tennessee: Under Tennessee Health Link, the state’s Home Health Program, community mental health centers can better serve high-need members. Also, the state’s Episodes of Care program has used a new VBP approach for individual behavioral health conditions.

The report includes descriptions and assessments of the models used in these three states, based on interviews with key stakeholders and publicly available materials. The authors considered the models’ challenges, successful and unsuccessful results, and adjustments. The final section includes a discussion specifically for California’s consideration.

Key Takeaways for Behavioral Health Models

Behavioral health providers and payers should be aware of several key takeaways in the report.

Total Cost of Care for Behavioral Health
The report’s findings suggest that models based on total cost of care may not be suitable for behavioral health. In a total cost of care arrangement, a group of providers assumes financial risk for the total cost of care for an attributed population, regardless of where services are provided.

Some reasons for this potential unsuitability include:

Complexity involved in dividing responsibility for total cost of care across physical health and behavioral health providers
Inability to manage downside risk
Behavioral health providers usually cannot influence the full continuum of care
Lack of standardized managed care contracting templates for behavioral health VBP

Episodic and Bundled Payment Models More Promising
The report suggests that episodic or bundled payment VBP models may be better for behavioral health. These models focus on discrete behavioral health treatments, events, or diagnoses. Evidence suggests that these models can improve some behavioral health access quality of care.

Cost Savings Still Uncertain
The report authors did find evidence that episodic or bundled payment VBP models could help improve behavioral health access and quality outcomes without raising overall Medicaid costs. However, it is unclear whether these models will create meaningful cost savings. These models may have to be adjusted to target cost reduction as well as improve care access and quality.

Preparing for Value-Based Care in Behavioral Health
The right EHR system can help behavioral health providers prepare for value-based care. Record and track client data and outcomes, create customized progress notes, and generate accurate reports with BestNotes, a behavioral health EHR solution built specifically for your practice’s needs. Contact BestNotes today to learn more, or schedule a live demo.

date:  Mar 03, 2020
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Oklahoma Behavioral Health and Addiction Treatment News Roundup: February 2020

As demand for behavioral health services grow, lawmakers and providers are attempting to address various mental health and substance misuse concerns across the nation. To understand the needs of their clients and the social and legislative trends that may affect their practices, behavioral health and addiction treatment providers must stay ahead of new developments in their states and communities.

Here are some of the major headlines that behavioral health or addiction treatment providers in Oklahoma should be aware of.

Oklahoma Seeks to Address State Suicide Rates

Suicide is still the 10th leading cause of death in the United States, according to new CDC data. From 2017 to 2018, the suicide rate increased by 1.4 percent. Meanwhile, Oklahoma saw a reduction in suicide rates in 2018-2019, the first such reduction since 2014-2015.

Despite these reductions, Oklahoma still has a significantly higher suicide rate than the national average. Oklahoma’s rate was 19 suicide deaths for every 100,000 people in 2017, compared to the national average of 14 per 100,000.

Advocates in Oklahoma are hoping to create community-based responses that could further reduce suicide rates. For example, the Northwest Center for Behavioral Health is using the program Zero Suicide to provide public schools with suicide prevention resources.

Opioid Lawsuit Funds Aren’t Reaching Oklahoma

Although Oklahoma is entitled to $829 million from settlements with drug companies or court orders, these funds have not yet been used for addiction treatment, as intended. In response to the nation’s opioid crisis, Oklahoma Attorney General Mike Hunter took opioid manufacturers and distributors to state court.

Behavioral Health EHR Solutions for Oklahoma

As a behavioral health provider in Oklahoma, you are working to address opioid addiction, suicide risk, and other mental health and substance misuse concerns. Additionally, you have to keep up with state and national requirements, such as outcome reporting and electronic prescribing.

BestNotes EHR solutions can be customized to your unique needs, helping you save time, reduce costs, and serve more clients effectively. Contact us today to learn more or schedule a demo.

date:  Feb 26, 2020
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How does FHIR-Based Interoperability Empower Behavioral Health Providers and Patients?

Whether you currently use an electronic health record (EHR) system, or are considering adopting one for the first time, you’ve heard about interoperability. This refers to the ability of different computer systems or software to exchange and use data.

For many years, U.S. healthcare has been divided into numerous “silos,” where different providers and health systems have their own collections of patient health data. Because different providers or organizations do not all use the same EHR, they may not be able to exchange data effectively.

However, changes in regulations and patient demand have encouraged greater collaboration among providers, which requires the sharing of patient health data. To share that health data in a meaningful way, interoperability between different software solutions is a necessity.

FHIR Offers Hope for Interoperability

Among the possible standards for interoperability, the Fast Healthcare Interoperability Resource (FHIR, pronounced “fire”) is becoming a standout option. FHIR is meant to allow data access much like how URLs are used to access web pages. FHIR tags different health data elements, or “resources,” with a unique identifier, similar to a URL. Developers use this to build standardized applications that allow data access, no matter what EHR is used.

The programming that different EHRs currently use are proprietary, meaning they have exclusive ownership and may not speak the same “language” as other EHRs. With FHIR, however, health tech developers can create specific applications that can be added to any core EHR. This creates enormous potential for innovation.

Provider Empowerment Through FHIR

For example, with an EHR that supports FHIR, an addiction treatment provider could add a FHIR-based app that provides progress monitoring for their clients. This could not only help improve client outcomes, but make the EHR itself more useful for the provider.

FHIR can also empower behavioral health providers to participate in more collaborative care models. Under these models, primary care providers are looking to collaborate with behavioral health providers within their own health systems as well as partnered behavioral health facilities in their communities. FHIR can encourage the effortless data exchange that such collaboration requires.

Interoperability Empowers Clients and Patients

Thanks to advanced technology, behavioral health clients and patients have more choices than ever in their healthcare. With this increasing choice, they are learning that successful healthcare often requires them to advocate for themselves. This often means having control over their own health data.

If a patient interacts with several types of providers or health systems, then they must be able to communicate with each one. For example, a primary care provider may refer an individual to a behavioral health provider. If these health providers can share data and effectively communicate with each other and their client, it’s easier to keep the client “in the loop” and make his or her experience less frustrating and more empowering.

Your behavioral health or addiction treatment practice can achieve greater interoperability, and all the accompanying benefits, with an EHR system that meets current standards like FHIR. BestNotes offers EHR and CRM solutions with features that help you collaborate and exchange information with those who need it. Contact us today to learn more or schedule a demo!

date:  Feb 21, 2020
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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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