For Healthplans in Oregon
As a result of healthcare reforms Healthplans across the country are challenged to improve access, improve outcomes and reduce health care costs. Healthplans are challenged to create alternative payment methods that include value-based contracts. Such contracts include pay-for-performance, risk-sharing and value-based payment.
AMHA-OR psychotherapists can offer a number of viable value-based strategies when making contracts with Healthplans.
Our members have technology that offers patients or approved professional referrers the ability to schedule tentative appointments and allows clients to manage routine appointments. Measuring timely access to services has value.
In healthcare, Category 1 services are fee-for-service methods that do not demonstrate measurable value and benefit to patients.
Patient reported outcome measures (PROMs) are proven strategies that demonstrate and improve outcomes in medical and behavioral health. The use of PROMs in patient-centered and coordinated care is recognized by both the federal government and the healthcare industry as linking value to services provided. Th use of PROMs moves payment to Category 2 where services are linked to measurable value.
Value Based Contracting
Linking patient reported outcomes measures to value is simple concept that requires only small changes in a provider's work flow and is made easier using technology that can gather data, save that data securely, and process the data to create graphical and statistical information which can be effectively and privately shared by psychotherapists with patients and their medical caregivers.
Sharing dis-identified outcomes information with Healthplans is useful because it allows the Healthplan to demonstrate the value of their coverage to their customers.