Coronavirus Could Speed Shift to Value-Based Behavioral Reimbursement

Behavioral Health Business

February 23, 2021

Study after study has shown that behavioral health treatment leads to better overall health outcomes and lower total care costs. But typical fee-for-service reimbursement models don’t account for services’ long-term impact.

As such, most behavioral health providers grapple with meager reimbursement rates and slim margins. But the coronavirus could finally change that, mainstreaming value-based care once and for all.

“The march towards value-based purchasing has been predicated on this idea that fee-for-service reimbursement doesn’t work,” said Chuck Ingoglia, president and CEO of the National Council for Behavioral Health. “And if ever we had a situation that proved that, it was this last year.”

Ingoglia made those comments during a recent webinar hosted by the talent solutions company Relias, which provides online analytics, assessments and learning for about 10,000 health care providers nationwide.

During the virtual event, Ingoglia identified the weakness of fee-for-service reimbursement as one of the most important lessons learned amid the pandemic. In 2020, providers of all shapes and sizes were forced to cut back their census to prevent the spread of COVID-19, putting even more financial strain on already overburdened behavioral health providers. 

Ingoglia said he’s hopeful for a more “rational reimbursement approach” in the future, and he’s not the only one.

In fact, Scott Palmer — executive director of strategic initiatives at Hazelden Betty Ford Foundation — predicts the behavioral health care industry will see an uptick in value-based reimbursement models in the year ahead.

“The pursuit of better outcomes at less cost is driving much of these trends, along with the expectations of the modern, info-rich patient/consumer, who wants choices, price transparency, up-front pricing, quality assurances, on-demand services and omni-channel support,” Palmer recently told Behavioral Health Business.

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