Behavioral health has lagged behind in the shift to value-based care, and a new paper from experts at Cigna outlines why these providers should consider making the switch along with the barriers they may face.
For example, there are significant technology gaps that may hinder uptake of value-based care, according to the report. Mental health providers are often slower than hospitals in adopting new electronic health records and other tech platforms critical to these models. Also, data gaps are a major challenge, with just 20% of mental health practices using measurement in their work, according to a 2018 JAMA study.
Stuart Lustig, M.D., national medical executive for behavioral health strategy and product design for the Cigna Group, told Fierce Healthcare that more than a few behavioral health practices are content with how things work under the status quo.
“I think for a lot of smaller providers, solo practices, mom and pop shops, that kind of thing, this is still going to be a heavy lift,” he said. “They may or may not have the electronic medical records that they need to do this kind of work. They may be perfectly happy with fee-for-service, particularly if they are working in areas where there are well-heeled patients who can afford to pay cash and may not even need to use their insurance in the first place.”
However, while there is still plenty of progress to be made, Lustig said there are bright spots to be celebrated, too.
For example, there’s a groundswell of support around the importance of measuring the quality of behavioral health care, according to the paper. Lustig said that includes backing from critical organizations like the American Psychiatric Association, the Kennedy Forum, the National Quality Forum and the Joint Commission.
“So I think that the field has been slowly shifting in this direction for a while, and it’s really coming together at this point,” he said.
Data suggest that when mental health providers are tracking outcomes, remission rates are higher and patients are more adherent to their medications, according to the report. Value-based care arrangements also allow for greater interoperability and data-sharing, which can drive improvements to outcomes, too.
Lustig said, for example, that as more behavioral health providers join these models, it becomes easier to match patients to those that meet their needs, such as connecting a young female patient with a clinician who has a history of working with those individuals.
Patients can’t be forced into relationships with clinicians through matching, he said, but having robust and reliable data surfaces insights like this to allow them to choose more effectively.
Continuing to build out a strong network and foundation for value-based care is a key strategic focus for Evernorth, Lustig said. The organization currently has 100,000 providers across the board sharing information with them, but they’re not yet designing or building contracts on those data, he noted.
“So that is our focus for the next year or so, to build out even more robustly the value-based contracts,” he said.
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