OVERVIEW AND PURPOSE
Health care payers are increasingly shifting away from fee-for-service payment systems that reward volume to value-based payment (VBP) models that incentivize high-quality, cost-effective care – or ‘value-based care’. While increased access to and coordination of behavioral health services is a policy priority for federal and state policymakers, the extent to which the behavioral health system is engaged in VBP is at various stages across the country.
Regardless, adoption of core competencies and best practices that drive efficient, improved outcomes for behavioral health populations is important. The tools, resources and information contained within this website were designed by the National Council for Mental Wellbeing through the Care Transitions Network program funded by Centers for Medicare and Medicaid Services. They are intended to support behavioral health providers in using quality improvement and population health management approaches to improve quality of care, patient experiences and reduce costs.
From September 2015-2019, the National Council for Mental Wellbeing, in partnership with Montefiore Medical Center, Northwell Health, the New York State Office of Mental Health, and Netsmart Technologies, operated the Care Transitions Network (CTN) initiative for People with Serious Mental Illness (SMI). This four-year program supporting behavioral health providers throughout New York State was made possible by a $29.4 million Transforming Clinical Practice Initiative grant awarded by the Centers for Medicare and Medicaid Services. The Care Transitions Network joined 29 other Practice Transformation Networks (PTNs) around the country working to create new and replicable models of care for vulnerable populations and helping provider practices move into the world of value-based payments.
The Care Transitions Network supported 275 behavioral health practices across New York State, a majority of which were outpatient specialty mental health and substance use treatment settings, collectively serving over 258,000 Medicaid patients. The network sought to empower providers serving people with behavioral health conditions with the tools necessary to reduce hospitalizations, improve outcomes, demonstrate value and succeed in the changing health care landscape through best practice implementation, improving engagement with behavioral health treatment, and increased focus on care coordination and care continuity.
By the end of the initiative, over 75% of the 275 enrolled practices had achieved sustained or benchmark improvement on targeted clinical measures such as reducing readmissions, improving follow-up post-discharge and metabolic monitoring for clients with co-morbid physical conditions. The program generated over $204 million in cost savings, largely attributable to reductions in all-cause hospital utilization. Participants reported marked improvement in financial management and analysis, using organized approaches for quality improvement, engagement with community partners, and internal capability to success in value-based arrangements.