5 steps to employer value-based care

Employers in mental health VBC must align metrics, manage medication, and hold all partners accountable.

Health plans looking to advance VBC in the mental and behavioral health space should work with providers to ensure that they have what they need to meet this challenge. Here are a few key steps they can take:

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1. Align on metrics that matter.

Plans should work with providers and initiate payment contracts that align provider reimbursement to mental and behavioral health outcomes—but not just any outcomes. A plethora of metrics exist, yet there is limited understanding of which are considered gold standards by mental and behavioral health experts. Furthermore, performance measurement is often oversimplified. As explained by the chief medical officer of a regional health plan, “Most programs focus on driving down utilization, but the more sophisticated argument is that increased utilization now will decrease long-term cost, which requires a multiyear measurement window.” Plans should work toward meaningful outcome metrics as opposed to process metrics.

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2. Manage medication anywhere, anytime with consistency.

Medication coalescence is important to achieve the goals of treatment and ensure that medications work correctly. Patient nonadherence can be a pervasive threat to health and well-being and carry an appreciable economic burden as well. In some disease conditions, more than 40% of patients sustain significant risks by misunderstanding, forgetting, or ignoring advice. Not taking medications how they are prescribed impacts value-based care plan results.

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3. Use anonymous data to provide value to employers.

Health plans and employers can benefit from collecting more anonymized information on populations, they should use this data alongside historical care utilization patterns to track and predict future mental and behavioral health needs. A bird’s-eye view of future needs would allow health plans to work with employers to deploy proactive interventions that prevent condition exacerbation and decrease long-term costs.

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4. Leverage a technology platform that empowers providers to deliver better quality care.

Simple visibility is needed to quickly identify the patients most likely to need provider attention. Look for actionable insights that distill complex data down to what is most essential for a provider to deliver better care, extend services, and scale a practice or business.

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5. Consider partners experienced and focused on healthcare innovation and value-based delivery.

Not all providers are ready to dive head-first into VBC arrangements. Health plans and providers should identify those organizations that are willing and able from a cultural, industry domain expertise, and infrastructure perspective. Experienced partners are already incorporating value-based models into mental healthcare (for instance, ShareMy.Health) and will become early adopters, while others will require a more gradual on-ramp to VBC programming.

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Final thoughts

During the COVID-19 pandemic, consumer-directed sharing and privacy were brought to the forefront of stakeholders’ minds and we should work diligently to keep them there. At ShareMy.Health, we’re leveraging these patient engagement practices as a springboard for VBC innovation to address long-standing, momentous problems. Investments in the mental and behavioral health system will be crucial, and our efforts are focused on fusing value-based solutions and fee for services models because both models need to be in place to reduce cost and increase value to all.

At ShareMy.Health, our work, however, does not end with VBC. There is much to be done in addressing related issues including, but not limited to, the lack of mental health parity and the disproportionate impact on underserved populations. As such, we should view VBC not as an endpoint, but rather as the first of many disruptive innovations that will transform physical and behavioral health.

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