Monday, June 8, 2015

Pitfalls of Value-Based Care in Behavioral Health

As healthcare reimbursement moves from a volume-based to a value-based payment model, technology will need to help in the implementation of this paradigm shift.  In theory, value-based payment seems to make sense.  Shouldn't the best treatment providers be financially rewarded?  Problem is, how do we measure performance?

Consider for a moment how education policy has tried to implement the analogue of value-based payment in schools.  No one disagrees that educational policy should somehow incentivize school and teacher performance.  Students, parents, teachers, administrators, and policy makers all seem to agree that test scores are not a meaningful reflection of a teacher's competence.  Yet test scores are what we're stuck with.

I am worried that behavioral health could fall in the same trap as the education system.  That is, policy makers will require the adoption of outcome measures that aren't meaningful to clients, don't reflect the quality of care provided, and fail to paint an accurate picture on a population level.  And once we are stuck with standardized measures that no one finds meaningful, just like the education system, we will be stuck with a necessary evil.

Technology solutions like Utila need to help policy makers and treatment providers avoid the obvious pitfalls.  Specifically technology can help the implementation of value-based payment in behavioral health by:

  • generating both provider and patient-generated outcomes data
  • striking a balance between population-wide and individualized metrics
  • streamlining the amount of data required of providers and clients
  • promoting interoperability of data collection systems
  • improving the validity of outcomes measures through innovative methods
  • capturing provider and client feedback throughout the implementation process

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