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.
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