The healthcare business is slowly transferring away from fee-based care fashions towards value-based care — however contracting in these preparations stays particularly tough for behavioral well being suppliers, mentioned Taft Parsons III, chief psychiatric officer at CVS Well being/ Aetna.

He highlighted this subject Tuesday throughout a panel dialogue on the Behavioral Well being Tech convention in Phoenix.

Parsons famous that his firm owns Oak Avenue Well being, a community of value-based major care facilities for adults on Medicare.

“[Oak Street] assumes the full international danger. We’ve contracts with loads of suppliers on the Aetna aspect, that are giant PCP practices which might be taking dangers, and we're additionally working inside behavioral well being to strive to determine what these value-based contracts seem like if you're simply speaking about specialty suppliers . – and the way in which we work with these teams is considerably totally different,” he defined.

Oak Avenue's major care suppliers assume nearly all danger of their contracts, Parsons mentioned. These suppliers do that figuring out that they’re accountable not just for their sufferers' bodily well being outcomes, but additionally for his or her behavioral well being outcomes, he added.

To raised make sure the success of those contracts, Oak Avenue has adopted a collaborative care mannequin that integrates behavioral well being companies with major care. The group employs its personal behavioral well being groups educated to handle the social determinants of sufferers' well being – a collaborative mannequin that makes it simpler for major care suppliers to handle their sufferers and guarantee they obtain holistic care, Parsons famous.

In Aetna's broader community of suppliers, cooperation doesn’t all the time go so effectively, he emphasizes.

“One of many issues that turns into a complexity inside our healthcare supplier community is once we don't have a risk-taking PCP, after which we’ve a behavioral healthcare supplier that wishes to take some danger – it turns into tough to determine how to do this should do. that attribution. How will we handle that contract?” Parsons famous.

In different value-based contracts, payers have give you methods to offer major care suppliers attribution for issues like improved diabetes outcomes, he famous.

“I’ve but to satisfy a major care supplier who doesn't need to take credit score for the outcomes of diabetes care. But it doesn't appear to matter that the one factor that was totally different was that they acquired the affected person into behavioral well being care,” Parsons defined.

There’s an understanding within the payer world that managing members with untreated behavioral well being issues is much dearer than offering applicable look after these circumstances, he famous.

But behavioral well being suppliers typically really feel like they’ve to repeatedly plead their case to payers, Parsons famous. These suppliers should repeatedly reassure payers that behavioral care will in the end scale back general healthcare prices to justify value-based contracts, he mentioned.

“That's not the bar we let orthopedic surgeons leap over,” Parsons famous. “For those who have a look at different specialties, nobody is telling kidney medical doctors that they will't proceed except they will display that they’re truly decreasing the general value of care. [Payers] is not going to permit their members to endure dialysis.”

Parsons acknowledged that that is “an inappropriate barrier” to transitioning behavioral well being suppliers, particularly within the midst of a nationwide psychological well being disaster.

Picture: Nuthawut Somsuk, Getty Photos