Value-Based Care Considerations for Providers

Value-Based Care Considerations for Providers

Much of the health care industry has taken significant strides to move reimbursement for medical services away from volume-based, fee-for-service models to value-based care models. Outside of the inpatient psychiatric hospital setting, value-based models have not reached the same footing in the behavioral health context. While the daily industry press is replete with articles highlighting payor desire to move to value-based behavioral healthcare, adoption has been slow and seemingly daunting. Impediments to value-based behavioral health care include difficulty in identifying standardized treatment models for chronic behavioral health conditions, data gaps and provider reluctance to take on financial risk associated with behavioral health conditions. While a disconnect between medical and behavioral health care is not a new phenomenon, we see the uptick in payor audits and recoupment claims against behavioral health providers as an indication that the fee-for-service model is ripe for evolution towards value-based care. Value-based care, while complex to apply to behavioral health, could help payors achieve the cost savings and predictability they are demanding, while giving providers and patients more flexibility in treating chronic behavioral health conditions. With …
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