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Anthem Blue Cross and Blue Shield in Ohio for has selected Boulder Care for a value-based contract to provide telehealth addiction treatment to Anthem members covered by employer-based, individual, or Medicare Advantage plans. Under the contract, Boulder Care will be paid a case rate to provide bundled services to treat members with addiction. The reimbursement model is intended to incentivize patient outcomes and long-term success in addiction treatment, in contrast with traditional fee-for-service reimbursement models where high visit and testing volume are incentivized even if not clinically necessary.

The Boulder Care digital clinic provides medical . . .

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The Medicare program is a health insurance program funded by the federal government for older adults, aged 65 and above, as well as younger individuals who have disabilities or end-stage renal disease. There are both strategic opportunities and challenges for health and human service provider organizations serving Medicare beneficiaries, who often have complex health and social support needs. As a result, Medicare plans are looking for innovative services and initiatives that demonstrate a return-on-investment in spending and consumer outcomes.

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Higher Telemedicine Use By Medicare Mental Health Specialists Linked To Slight Increase In Rural Access
Medicare mental health specialists with high uptake of telemedicine mental health services between 2018 and 2023 had a 0.88 percentage point higher share of services provided to fee-for-service (FFS) beneficiaries in rural areas, compared to mental health specialists in the lowest telemedicine uptake quartile, according to a recent study. Much of the increase in rural service use was due to existing patients moving farther away from their specialists, rather than new rural beneficiaries seeking out… Read

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