PsychU Spotlight

Did You Know?

• In a 2019 survey of over 1,200 payers, nearly all respondents indicated some focus on increasing value-based reimbursement with providers. Over 90% stated that they offered pay-for-performance arrangements as well as other alternative payment models.

  Reference:
  Otsuka America Pharmaceutical, Inc. & Lundbeck, LLC. (2019). Trends in Behavioral Health: A Population Health Manager’s Reference Guide on the U.S. Behavioral Health Financing & Delivery System (2nd Ed.). Otsuka America Pharmaceutical, Inc. https://www.psychu.org/guide-second-edition/.

• According to a recent survey, only 58% of responding provider organizations were realizing any revenue from their value-based reimbursement or pay-for-performance arrangements.

  Reference:
  OPEN MINDS. (2019). Where are we on the road to value? The 2019 OPEN MINDS performance management executive survey. https://www.openminds.com/market-intelligence/resources/where-are-we-on-the-road-to-value-the-2019-open-minds-performance-management-executive-survey/.

• Behavioral health organizations often struggle to demonstrate value. Some issues faced include developing appropriate, standardized outcome measures and addressing health tech interoperability and data sharing difficulties.

  Reference:
  OPEN MINDS. (2019). Where are we on the road to value?: The 2019 OPEN MINDS performance management executive survey. https://www.openminds.com/market-intelligence/resources/where-are-we-on-the-road-to-value-the-2019-open-minds-performance-management-executive-survey/.

• A 2017 study found that having a value-based payment model improved community health clinics’ fidelity to implementing key aspects of the Collaborative Care Model (CCM). This finding is significant as it demonstrates that VBP models may improve evidence-based mental health intervention.

  Reference:
  Bao, Y., McGuire, T. G., Chan, Y., Eggman, A. A., Ryan, A. M., Bruce, M. L., Pincus, H. A., Hafer, E. & Unützer, J. (2017). Value-based payment in implementing evidence-based care: The mental health integration program in Washington state. American Journal of Managed Care, 23(1), 48–53.

• Follow-up after hospitalization and readmission rates were cited as two of the most popular performance measures for VBR in a 2019 survey of health and human service executives.

  Reference:
  OPEN MINDS. (2019). Where are we on the road to value?: The 2019 OPEN MINDS performance management executive survey. https://www.openminds.com/market-intelligence/resources/where-are-we-on-the-road-to-value-the-2019-open-minds-performance-management-executive-survey/.