What Is Optum's Reimbursement Rate For Peer Support Services.

Behavioral health proponents often tout value-based care as an efficient fashion for providers to deliver ameliorate services, giving them the run a risk to be paid based on the quality outcomes they produce for patients rather than the historically low fee-for-services reimbursement rates they typically receive.

The payment model has picked upward steam in recent years, as new federal rules have modernized statutes and laws in an attempt to reduce obstacles to value-based payment and intendance coordination. Plus, the coronavirus has accelerated things farther, reinforcing behavioral wellness's office in improving overall health outcomes and lowering total care costs.

But not all value-based care models and adoption practices are created equal.

"If we really desire to change the system to exist focused more on value [and] to incentivize those little touch points that brand such a divergence in care that aren't necessarily contiguous, we've got to motility toward value-based payment, toward more of a capitated or global payment rate and toward more of a population wellness approach," said Katherine Knutson, the senior vice president at United Wellness Group and the CEO of United Health'south behavioral health arm, Optum Behavioral Care.

Knutson weighed in on the topic during a recent webinar hosted past the health care professional arrangement RISE. During the virtual result, panelists talked about strategies for creating a behavioral wellness intendance model driven by wellness outcomes.

One strategy that Knutson — who is an adult and child psychiatrist by training — talked upward during the discussion was the employ of peer workers, who are professionals that have personal experience with behavioral health bug and who provide mentorship and advancement to others going through similar experiences.

Peers are a growing workforce in behavioral health, with an estimated 30,000 or and so workers employed nationwide. Additionally, over three-quarters of states reimburse peer services through Medicaid, but non all payers are as progressive.

Withal, she stressed their importance to providers in the space.

"These are people with lived experience [dealing] with substance utilize and mental health," Knutson said. "Bring in peers to help align with people [and meet] them in the community. These are … things that we tin can do to assistance better the access and … the quality of care ultimately leading to better health outcomes and costs."

Various published studies have fabricated the case for the use of peers in behavioral health care, and Knutson noted that peer workers could exist a novel mode to assist health care systems burdened past limited resources. I reason for the lack of resources and personnel in behavioral health is the low reimbursement rates providers typically are paid on a fee-for-services basis.

"I would rather go to… a global payment model where we say, 'This is the amount of coin [providers] have … to deliver all the care that's needed,'" Knutson said. "How can a provider evangelize these services in a mode to where they're maximizing the resources and maximizing those health outcomes? That's when you see those investments in peer back up."

Knutson besides noted that the behavioral health care industry, in its motion toward value-based intendance, needs to develop better measurement tools for patient outcomes.

"Right at present, the truthful health consequence measures in behavioral health are the person-reported wellness outcomes [and] the symptom rating scales — so like the PHQ-ix for depression, for example — simply that's really limited," she said. "Yous're asking somebody to think back over the last ii to 4 weeks and … measure their symptoms. If we had ways to measure out outcomes in real fourth dimension and symptoms in real fourth dimension — even through passive devices — it would exist a true game changer."

Kyle Coward is a former mental wellness professional with more than a decade of experience as a freelance writer. He also fancies himself as an amateur pastry chef who isn't shy of showing off his White Sox fandom in the office.

Source: https://bhbusiness.com/2021/04/13/peer-workers-better-outcome-measures-key-to-successful-value-based-care-in-behavioral-health/

Posted by: thompsonthencerest70.blogspot.com

Share this post