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Executive Summary
With an estimated one in four adults having a diagnosable mental health condition and over 60 million people using substances, the need for person-centered, culturally appropriate, high quality behavioral health treatment has become a top priority in the United States. These disturbing statistics have led to a nationwide push to enforce parity laws, prioritize health equity, and integrate physical and behavioral health. In addition to expanding access and proving the care being offered is effective, stakeholders in the behavioral health field are calling for a corresponding change to the reimbursement model, one where incentives are based on value instead of volume.
The result has been an accelerated push towards Value-based Care (VBC) contracts. In 2021, CMMI published a report stating that they aim to have all Medicare beneficiaries and the vast majority of Medicaid beneficiaries on VBC arrangements by 2030. Commercial insurers are also showing more interest and many have already established VBC agreements with expansion plans to include more of their network. While these changes are good for consumers, behavioral health providers are feeling the pressure because their operations were built around a fee-for-service payment methodology.
Many are turning to technology to streamline their workflow and better position themselves for the changing reimbursement landscape. In this paper, we hear from a variety of experts in the behavioral health space regarding which steps providers should be taking when preparing for VBC.
The standards of behavioral health care are changing.
Measurement-based care (MBC) is quickly becoming the expected standard of care.
Empirical evidence shows that MBC improves treatment and patient outcomes across numerous mental health disorders. Appropriate implementation of MBC is particularly challenging for treatment providers working with patients suffering from Substance Use Disorders (SUDs), who face a range of specific barriers to recovery.
About the Author
Lucy F. Faulconbridge is Director of Main Line Therapy and Psychological Services, LLC, a private mental health clinic in Pennsylvania.
Dr. Faulconbridge received her PhD in Behavioral Neuroscience and Clinical Psychology from the University of Pennsylvania and completed her Clinical Internship training at Weill Cornell Medical School in New York.
Dr. Faulconbridge served on the full-time faculty in the Department of Psychiatry at the University of Pennsylvania’s Perelman School of Medicine between 2010 and 2016 and she was appointed Director of Research in The Center for Weight and Eating Disorders from 2011 to 2016. From 2010-2015 she conducted a large randomized controlled clinical trial, funded by a K23 award from the National Institutes of Health (National Heart, Lung and Blood Institute), which examined a novel treatment for obese, depressed individuals at risk for cardiovascular disease. Dr. Faulconbridge is a licensed clinical psychologist and a certified cognitive-behavioral therapist by the Academy of Cognitive Therapy.
She is the author of 28 peer-reviewed publications and 8 book chapters, she has given more than 60 guest lectures and presentations, and she has appeared on NPR’s Voices in the Family and the Think-Act-Be podcast. Dr Faulconbridge has served on the Scientific Advisory Board for ERP Health, LLC, since 2020.
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