Anthem launched a new value-based payment initiative for our large-volume behavioral health providers and substance use disorder (SUD) facilities serving commercial members. Anthem Behavioral Health Provider Collaboration is a pioneering venture with a mission to recognize—through reimbursement incentives—health care professionals and facilities that offer improved treatment outcomes and quality clinical care.
Value-based Payment Opportunity
The National Alliance Health Purchaser Group identified Anthem behavioral health value-based payment program as the industry leader among health care plans. There are three distinct recognition categories under this program:
- SUD/Behavioral Health Facility
- Behavioral Health Outpatient Provider
- Medical/Behavioral Health Integration using one of three service models—fully integrated, co-located or coordinated
Participating Health Care Professionals
Our behavioral health value-based payment program leverages the Healthcare Effectiveness Data and Information Set (HEDIS®) to measure the quality of care that patients receive. Visit the HEDIS website to learn more about these measurement guidelines.
Current HEDIS measures for behavioral health clinical quality
Integrated Behavioral Health Care
80% of people with a behavioral health disorder will visit a primary care provider at least once a year.1
Adults living with serious mental illness die on average 25 years earlier than other Americans, largely due to treatable medical conditions.2
30-50% of patient referrals from primary care to an outpatient behavioral health clinic do not make the first appointment.3
Resources for Integrated Health Care
For additional information or to ask questions, email the Behavioral Health Provider Collaboration team.