You may have heard that “value-based care” is attracting attention in the healthcare world. In fact, some predict that it will help define the future of healthcare.
But what, exactly, is this type of care—and how does it apply to behavioral health?
Value-Based Care Explained
Value-based care (VBC) is a model of healthcare reimbursement based on the quality of the treatment delivered rather than the number of services provided. In other words, the provider is paid for the patient’s positive outcomes.
Paying for outcomes requires providers to measure and report on patient progress. This makes it much more reliant on data analytics than traditional fee-for-service reimbursement models. A shift toward VBC will require providers in both physical and behavioral healthcare to adopt tech solutions that can efficiently track patient metrics—and then generate reports on those metrics to show insurance companies and other payers.
Within behavioral health, outcomes that indicate a high value of care and justify high reimbursement might include:
- Reducing hospitalization for mental health among your patient population
- Meaningfully reducing patient symptoms
- Reducing patient symptoms in a shorter number of treatment sessions
Looking to learn more about value-based care? Check out our VBC Whitepaper.
Difference Between Measurement-Based Care and Value-Based Care
Measurement-based care (MBC) and value-based care (VBC) are closely related, but the terms are not interchangeable.
Value-based care refers to the type of contract providers have with their payers, and how their reimbursement is determined. Measurement-based care is a treatment modality that collects information on patient symptoms and progress. Providers can use MBC to demonstrate their worth to payer who are willing to reimburse based on results.
Under MBC, the provider assesses a patient’s progress in treatment by administering objective measurement tools, such as symptom rating scales. Such data enables you to draw more accurate conclusions about the efficacy of treatment, and thus improve long-term strategies.
How Value-Based Care Affects Behavioral Health
The behavioral health industry has historically lagged behind physical healthcare in adopting value-based and outcomes-based care models. This is changing rapidly as more behavioral health groups embrace VBC and MBC. However, many behavioral health providers still feel unprepared to make the switch, and are likely being underpaid compared to the true value of their services.
The move to value-based care will affect the behavioral health world in many ways. Fortunately, the effects will be positive, and the switch to this reimbursement model is far less daunting than many assume—if you have the right technology infrastructure in place.
- IT Infrastructure: Practices that engage in VBC will become more reliant on the IT solutions that make their workflow efficient. Tech solutions will need to easily implement, record, and report results from patient measurement tools. That’s why behavioral health software solution companies like Valant are designing MBC-focused practice management solutions.
- Better Patient Outcomes: Research shows that measurement-based care yields better results for behavioral health patients, so adopting it in service of VBC models will improve results for your patients and your practice.
- Higher Reimbursement: Under VBC, outstanding results command higher payments. Currently, many payers are already willing to offer higher rates to practitioners who demonstrate favorable MBC outcomes. If you are good at what you do, you’ll be rewarded for the full value of your talents.
- Renegotiating Contracts: Behavioral health practitioners who switch to a VBC model may need to educate their payers on the practice and renegotiate their contracts to reflect this. To hear experts talk about how to negotiate successfully with payers, check out this on-demand webinar.
- Industry-Wide Adjustment: Getting the behavioral health industry as a whole to adopt MBC and value-based reimbursement will be a process of education and adjustment.
- Efficiency is Paramount: Some practitioners worry that the healthcare world’s move to VBC will just make more work for providers. After all, it requires gathering more data and creating reports. Luckily, tech solutions exist to help automate data collection, analysis, and reporting, so switching to VBC need not mean more busywork.
- Your Work Will Speak for Itself: Reimbursement based on value means that the success of your practice will rest on how well you help patients, not just on how many new patients you can bring through the door. It will become ever more important that all providers at a practice are well-trained and professionally supported. Providers will need to lean hard into their strengths and address any areas of weakness in their treatment plans.
VBC and the Future of Healthcare
As value-based care gains momentum, the advantages to practitioners of learning about and implementing this care model will only grow. Providers who want to stay on the leading edge of healthcare practices would do well to learn about VBC and to invest in the technology that makes its implementation possible.
Value-based care, after all, supports you in your ultimate goal: to help clients realize positive results in their behavioral health journey.