BlueCross BlueShield Starts Region's First Value-Based Payment Model

BlueCross BlueShield of Western New York recently announced the region's first behavioral health value-based payment agreement with Value Network - a behavioral health care collaborative with more than 100 area providers, including BestSelf Behavioral Health, Endeavor Health Services, Horizon Health Services, and Spectrum Health and Human Services.

A value-based payment model focuses on quality of care, rewards health care providers for complete care management of their patients' health, and allows them to manage patients with more flexibility.

BlueCross BlueShield is the first local health plan that will follow this approach, rewarding behavioral health providers for delivering quality mental health and substance use disorder treatment to its members. This follows the health plan's rollout of Best Practice, a value-based approach for compensating primary care doctors in January 2017. Read more here.

Lyft is partnering with Unite Us to coordinate rides to job interviews, food pantries and mental health services.

The collaboration will enable Unite Us, a social determinants of health technology company, to provide ride-enabled social service referrals through its platform.

The New York-based, venture-backed company  builds coordinated care networks to connect health and social care providers. Coordinators and service providers who use Unite Us to make social care referrals can now order or schedule a Lyft ride on demand for patients.

For the ride-hailing company, it's the next logical next step in a strategy to address more insecurities related to transportation.

Transportation is a barrier for people to access social care. Getting a ride to a job interview, a community center, a food pantry or other community-based organization is one step toward an individual meeting goals. Read more here.

First Lady Chirlane McCray's signature mental health initiative ThriveNYC has faced withering criticism for spending hundreds of millions of dollars with few concrete results to show for it. But amid increasing scrutiny the de Blasio administration is seeking to put those concerns to rest as the Office of ThriveNYC for the first time releases detailed data tracking the outcomes of dozens of programs that have been launched under the Thrive banner.

It's part of a reclamation project for McCray and her husband, Mayor Bill de Blasio, who have heralded ThriveNYC as a one-of-its-kind roadmap and national model, but struggled to show evidence of its effectiveness, particularly whether it was helping New Yorkers with serious mental illnesses. The mayor and first lady brought Susan Herman from the NYPD to the mayor's office to establish better benchmarks, data-tracking, and standing for the program, and Herman is now showing the initial results of her work as executive director of ThriveNYC. Read more here.

Article of interest:  Chirlane McCray's ThriveNYC Mental Health Program Gets a Reboot - NYC

enhanced requirements - in the Care, Treatment, and Services (CTS) and Leadership (LD) chapters of the accreditation manual - are designed to improve quality and safety of care for patients being treated for substance use disorders.

 

During the development process, The Joint Commission evaluated literature and national guidelines, and engaged stakeholders to determine how enhancing the standards would help improve the quality and safety of care. The Joint Commission concluded that enhancing standards applicable to addiction treatment providers was needed in the areas of:

  A new R3 Report was developed to explain the rationale and research behind the new and revised requirements.

 

Read the R3 Report.

It is not uncommon, when our team asks managers of provider organizations to describe the value of their services, to hear the refrain, "We serve the sickest patients." Usually that statement is "metrics free" as there are few (or no) metrics to back it up.

But by the end of the payer townhall session,  The Payer Perspective: An OPEN MINDS Forum On The Performance Management Metrics That Health Plans Are Looking For From Providers, at The 2020 OPEN MINDS Performance Management Institute, it was clear that response (and the lack of measures) is not enough. The faculty-Lori Fertall, Director of Value-Based Programs, Community Care Behavioral Health Organization; Cathy Lipton, M.D., National Medical Director, Institutional Programs, Optum; Susanna Kramer, Director of Performance Evaluation, Community Behavioral Health; and Melissa Nichols, Network Performance & Planning, Beacon Health Options-all spoke to their organizations' perceptions of "value," their move into pay-for-performance contracting, and its role in their future strategy.