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
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