Introduction

In an effort to drive better care, lower costs, and improve collaboration in behavioral health, Evernorth, a subsidiary of Cigna, has launched a groundbreaking value-based care management program. This program aims to establish standardized benchmarks in behavioral health and create a more efficient and effective system for providers and payers alike. With approximately 44,000 participating providers at its launch, Evernorth’s innovative program represents a significant step forward in the industry. By aligning payers and providers on how to measure success in treatment, the program seeks to enhance patient outcomes while reducing administrative burdens.

The Need for Standardized Metrics in Behavioral Health

While value-based or measurement-based care has gained traction in medical care, its progress in behavioral health has been slower. Evernorth recognizes the crucial role of metrics in driving the adoption of value-based models and improving patient care. Currently, providers use a wide array of measures across multiple payers, leading to administrative challenges and a lack of trust in the system. By establishing consistent, repeatable measures that are broadly agreed upon, Evernorth aims to streamline the process and deepen relationships with providers.

The Goals of Evernorth’s Measurement-Based Care Program

Evernorth’s program focuses on identifying and implementing key metrics to measure performance in behavioral health. During the initial phase, metrics such as appointment wait times and total cost-of-care savings will be utilized. However, the program doesn’t stop there. The Evernorth team, in collaboration with providers, will continue to develop and incorporate new metrics as the program evolves. This iterative approach ensures that the program remains dynamic and responsive to the changing needs of patients and providers.

Collaboration with Providers

To ensure the success of the program, Evernorth has partnered with a diverse group of providers. These providers include health coaches, therapists, and prescribers with expertise in treating a wide range of behavioral health conditions. By working closely with these providers, Evernorth aims to move the needle and drive improvements in care. The program’s focus on shared metrics throughout the customer journey enables both payers and providers to gain valuable insights into access and outcomes, ultimately benefiting everyone involved.

Minimizing Administrative Burdens, Maximizing Benefits

Evernorth recognizes the importance of minimizing administrative burdens for providers. By incorporating measurement in ways that reduce paperwork and maximize benefits, the program aims to free up providers’ time and energy for patient care. The goal is to create a system that allows providers to focus on what they do best while still ensuring that accurate measurements are captured. This balance between administrative efficiency and quality care is crucial for the success of the program.

The Impact of Evernorth’s Measurement-Based Care Program

The introduction of Evernorth’s innovative program has the potential to revolutionize behavioral health care. By establishing standardized benchmarks and metrics, the program will drive better care outcomes and lower costs. It will also foster greater collaboration between payers and providers, leading to a more integrated and patient-centered approach. Through the collection and analysis of data, the program will provide valuable insights that can inform decision-making and drive continuous improvement in behavioral health care.

Benefits for Patients

The primary beneficiaries of Evernorth’s measurement-based care program are the patients themselves. By implementing standardized metrics, the program ensures that patients receive timely access to care and experience improved outcomes. With a focus on value-based models, the program incentivizes providers to deliver high-quality, cost-effective care. Ultimately, this leads to better patient experiences and improved overall well-being.

Benefits for Providers

Providers also stand to benefit from Evernorth’s program. By utilizing standardized metrics, providers can streamline their administrative processes and reduce paperwork. This allows them to focus more on patient care and less on administrative tasks. Additionally, the program’s emphasis on collaboration fosters stronger relationships between providers and payers, creating a more cohesive and efficient system. By incorporating measurement in a way that maximizes benefits, providers can achieve better outcomes for their patients while minimizing administrative burdens.

Benefits for Payers

For payers, the program offers numerous advantages. By aligning with providers on standardized metrics, payers can assess and compare the performance of different providers. This enables them to make informed decisions about network composition and reimbursement rates. Additionally, the program’s focus on value-based care and cost savings aligns with payers’ goals of providing high-quality care while managing costs. By investing in innovative approaches like Evernorth’s measurement-based care program, payers can drive better outcomes for their members and enhance their overall value proposition.

The Future of Behavioral Health Care

Evernorth’s measurement-based care program represents a significant step forward in the evolution of behavioral health care. By establishing standardized benchmarks and metrics, the program paves the way for a more integrated, efficient, and patient-centered system. As the program evolves and incorporates new metrics, it will continue to drive improvements in care outcomes and collaboration between payers and providers. With a focus on value-based models and reducing administrative burdens, Evernorth is shaping the future of behavioral health care for the better.

Conclusion

Evernorth’s introduction of an innovative measurement-based care program for behavioral health marks a crucial milestone in the industry’s quest for standardized benchmarks. By aligning payers and providers on how to measure success in treatment, the program aims to drive better care, lower costs, and improve collaboration. Through the utilization of shared metrics and an iterative approach, Evernorth’s program empowers providers to deliver optimal care while minimizing administrative burdens. Ultimately, this groundbreaking program will revolutionize behavioral health care, ensuring that patients receive timely access to quality care and experience improved outcomes.