Two Health Plans, Same Value-Based Data Challenge

Over the past year, I’ve met with countless health plan and provider organization executives, and one subject always comes up—the current and growing financial challenges for provider organizations. While the pandemic and inflation have increased the costs of delivering services, fee-for-service reimbursement rates are not following suit. Most executives agree that the solution is that provider organizations should be reimbursed based on value rather than volume, but there is a lack of consensus about what exactly constitutes "value."

The numerous challenges of moving toward provider reimbursement based on value in the behavioral health field were explored . . .