Grass Roots Mental Health Professionals in Oregon are First to Offer Healthplans Alternative Payment with Value Based Reimbursements
Healthcare providers are often criticized for not being in the forefront of innovation. Oregon has been at the forefront of healthcare reform and is rolling out CCO 2.0 as a continued healthcare reform initiative. To support CCO 2.0 a small provider-led company, Private Practice Cloud, is releasing ConnectingCare, a model to enhance quality in mental health service delivery.
Healthplans and blogs across the United States are talking a lot about alternative payment models including value-based payments and pay-for-performance. One might think, that with all the seminars and white papers being published on the importance of moving from volume to quality, someone would come up with a mental health/substance use model that provides useful feedback to patients, physicians, mental health professionals and Health plans.
AMHA-Oregon, a small multidisciplinary group of mental health professionals in Oregon, has embraced Oregon’s 2.0 initiative with a goal to demonstrate the quality of private practice mental health services. The group has adopted an alternative payment model that has caught the interest of several Healthplans in Oregon and Washington. A Independent practice association of of mental health professionals in New York are reaching out to AMHA with the goal of using the ConnectingCare technology and model to obtain alternative payment contracts.
While there is significant interest in alternative payment methods there have been thus far been no concrete ideas that can be applied by a solo private mental health practitioner or multi-faceted mental health clinics, which then can be scalable to large populations. That is changing.
AMHA-Oregon mental health professionals are pushing from a provider perspective to create what can realistically be done to deliver and measure quality. Put simply, ConnectingCare implements quality measures for access, coordination with physicians and incorporation of patient reported outcome measures (PROMs) as a routine part of mental health care
Mike Connor, PhD a founder of Private Practice Cloud, in addressing the need, stated: “The solution to the alternative payment challenge was to stop trying to create better ideas from the top down. Instead, we realized that innovators in healthcare need to reverse engineer a solution based on what mental health professionals, physicians and patients can do and find helpful. We built what has value where it matters.”
Private Practice Cloud incorporates measurement tools that are simple, widely understood and evidence based. These tools are enhanced with simple documentation, analytic and reporting capabilities. The tools are patient-centered, inform the clinical process, and document the value of mental health services.
After speaking with Healthplans representatives, AMHA-Oregon and several groups attempting to form in New York believe that mental health professionals in private practice, with the support of Healthplans, can easily and inexpensively achieve the following goals:
Value-based reimbursement. Develop a viable model for value-based reimbursement in behavioral healthcare that promotes and incents effective and cost-effective treatment.
Patient Reported Outcome Measures (PROM). Implement the value of incorporating PROMs into behavioral healthcare.
Timely access to care. Ensure timely access to urgent and routine behavioral healthcare.
Coordination of care. Implement effective coordination of care among behavioral health and medical providers.
Technology. Implement effective, efficient, and secure technology in the delivery of behavioral healthcare services and in achieving the goals described in items 1-4 above.
Economy of scale. Implement group practices and associations that can attract and retain a sufficient number of providers to support goals 1-5 above.
The cost of Private Practice Cloud’s ConnectingCare software, as implemented by AMHA-Oregon and other group practices is insignificant and not dependent on a particular mental health EHR. Providers can continue to use their current EHR and billing system if they want. Or they can use the Private Practice Cloud toolset.
For more information contact Michaele Dunlap, PsyD, AMHA, 503 227-2027