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As the mental health care industry continues to evolve, new terms emerge that are crucial to understanding the future of mental health. Value based care is one of those terms, because it changes the entire service reimbursement model for mental health providers. When considering fee for service vs. value based care, it's important to understand what value based care is, and how it will be impacting mental health service delivery and billing.

Value Based Care Definition

Value based care definition: a healthcare and mental health concept referring to a reimbursement model that is based on quality of care rather than quantity. It relies on accountability among providers and positive outcomes in clients.

Characteristics of a Value Based Care Model

Where traditional care is based on the quantity and type of care a provider gives, a value based care model is based on the result of that care (i.e. positive vs. negative patient outcomes). Value based care rewards providers based on the quality of care they provide.

The value based care model places a significant emphasis on providers addressing their patients' needs as comprehensively as possible in a limited number of visits, rather than treating clients and waiting for them to return over continuous periods of time. This results in the ideal value based care model: better care for individuals, better health for the community, and a lower cost of care.

Benefits of Value Based Care

1. More Efficient Care & Greater Patient Satisfaction

Value based care models hinge on the delivery of high-quality services. This means mental health providers will need to prioritize building strong connections with their clients and offering the most effective mental health solutions. This approach not only boosts patient satisfaction, but it also leads to greater financial rewards for providers. By focusing on delivering superior care, providers are able to optimize outcomes for themselves and their clients.

2. Reduces Unnecessary Costs & Improves Outcomes

Value based care is centered around the quality of care provided, rather than the quantity of sessions or interventions. This means that clients will only pay for services that they truly need and that will be effective for them. The main benefit of value based care is that clients will be offered personalized solutions that will lead to better long-term outcomes. Value based care recognizes and rewards these positive outcomes for both the client and the provider.

3. Prices Will Reflect Value

Mental health services are often priced according to supply and demand principles, meaning prices are higher than many can afford. When using a value based care model, price changes can reflect the value that services have for patients. With the focus placed on the individual client rather than how many services are provided, it will become easier to tie the prices of services to the value they provide.

4. Creates A Healthier Community

One of the main benefits of value based care is the potential to help communities as a whole become healthier. Financial rewards are tied to the satisfaction of clients and their positive outcomes. This means that the more clients are satisfied with their care, the more stable mental health organizations and providers will be.


Are Value Based Care Solutions the Future of Mental Health Services?

Value based care solutions are quickly becoming popular in government agencies, especially for Medicaid, Medicare, and in certain states. With the heavy influence of these programs, it’s likely that more providers will start to benefit by using value based care models. There are still challenges to work through, such as interoperability with current systems, how to fairly implement it value based care solutions, and how to adapt from other care models to value based care. Many experts are convinced that while change may be slow, it will be positive over time. For now, it looks like value based care is here to stay, and mental health providers will need to transition towards this model in order to ensure government funding and reimbursements.

How EHR Mental Health Software Supports Value Based Care Models

Some EHR mental health software programs are ready to support providers who want to start exploring a value based care model. For example, EHR analytics tools can be very helpful for value based care. Predictive analytics and dashboards with KPI’s can help assess unmet needs in the community and allow providers to focus treatments where they have the most value.

Value based care trends are also having an impact on how data is conceptualized, collected, and analyzed. Providers are looking for EHR technology that enhances workflows, and incorporates value based care management tools. The value of data in improving patient outcomes is significant and agencies should continue to increase the adoption of new technologies to support this.

When agencies and EHR software developers work together to meet the needs of the community, the end result will be a software that can help increase value based care solutions and positive client outcomes.

Looking for a software to help you navigate this new care landscape? Exym EHR can help.

Exym is a comprehensive EHR software solution designed specifically for behavioral health agencies. Trusted for 20+ years, our intuitive and customizable software empowers providers to improve client outcomes, manage revenue cycles, and increase agency efficiency. Exym allows you to spend more time on what matters most- the clients in your care.

Clinicians are invited to book a demo, or visit our Clinical page to learn more about the ways Exym helps mental health providers adapt to new care models and reimbursement criteria.

Jessica Carey
Post by Jessica Carey
May 30, 2023