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What You Should Know About Value-Based Care

What You Should Know About Value-Based Care

posted by: Nicole Hovey date: Feb 12, 2019 category: Blog comments: Comments Off on What You Should Know About Value-Based Care

Value-based care has gained traction in recent years, and it is expected to be a significant trend in the global healthcare market in 2019.

Compared to other specialties, behavioral health has been slow to adopt a value-based payment (VBP) model. As mental and behavioral health draws more attention and addiction-treatment needs persist, providers must prepare to transition their practices to VBP.

A major factor in the acceleration of value-based care is the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This law changed the payment system for doctors who treat Medicare patients.

Payment provisions under MACRA will take effect this year, prompting many providers to focus more on overall patient health and positive outcomes. However, many payers are still working out the best methods for incorporating VBP into the realm of behavioral health.

Slower Behavioral Health Adoption of Value-Based Care

While the VBP is gaining traction among physical healthcare providers, behavioral health services, including addiction treatment, have lagged behind. This is partly due to the difficulty in defining outcomes for behavioral health.

VBP is meant to reward care quality and cost-effectiveness, compared to the traditional fee-for-service (FFS) model. This means that VBP focuses more on patient outcomes.

Patient outcomes can be difficult to define and measure in behavioral health and addiction treatment. Generally, “improved functioning” is the main goal, which can look different for each patient or condition.

VBP has become popular in the real of physical health because many providers have been criticized for allegedly over-diagnosing, over-treating, and over-prescribing. In contrast, behavioral health issues tend to be underreported, and treatment resources underutilized.
According to one study, most patients referred to psychotherapy only attend one or two sessions.

Importance of Changing to VBP in Behavioral Health

While it is challenging to define value and outcomes in behavioral health, the use of VBP models can significantly help reduce healthcare costs. In 2013, mental health disorders were found to be responsible for $201 billion in health spending.

Most Medicaid VBP arrangements are focused on physical health services, but many payers have become more interested in applying the VBP model to behavioral health, as well. According to a 2015 report by the Medicaid and CHIP Payment and Access Commission, Medicaid is the largest payer for behavioral health services in the nation, accounting for 26 percent of total spending.

Behavioral health and addiction treatment patients often have complex health needs that can increase emergency department visits. This patient population also tends to have concurrent disorders that drive up health costs.

For example, one study of patients with both depression and diabetes suggested that including interventions to reduce depression was more cost-effective than standard diabetes care alone. This requires more collaboration and data-sharing among different providers.

Outcomes are important for the VBP model, but you can’t determine outcomes without data. Fortunately, the right EHR program can help you track this information.
Enter and track patient data accurately with BestNotes, a behavioral health EHR solution built specifically for your practice’s needs. Contact us today to ask questions, learn more, or schedule a live demo.

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