1. Introduction

Evernorth Health Services, a leader in healthcare innovation, is taking a significant step forward in the field of behavioral health by launching an innovative measurement-based care program. This program aims to enhance patient outcomes and drive consistency in care delivery while also addressing the administrative burdens faced by providers. By creating standardized metrics and fostering collaboration with providers, Evernorth is reinforcing its commitment to improving health and value for patients.

2. The Need for Measurement-Based Care in Behavioral Health

Measurement-based care, also known as value-based care, has long been established in the realm of physical health. However, the adoption of this approach in behavioral health has been limited. Currently, providers and payers rely on various measures and information-sharing methods, such as spreadsheets and claims submissions, to assess the quality of care in behavioral health. This lack of consistent, repeatable measures has led to increased administrative work and a lack of trust among provider partners.

Recognizing the importance of measurement in delivering quality behavioral health outcomes, Evernorth aims to bridge this gap by implementing a measurement-based care program. The program will focus on identifying key measurements throughout the patient journey and creating standardized ways to capture them. By doing so, Evernorth aims to drive improvements in care, cost, and collaboration, while also reducing administrative burdens for providers.

3. Evernorth’s Approach to Measurement-Based Care

Evernorth understands that delivering quality care requires a collaborative effort between payers and providers. To ensure the success of the measurement-based care program, Evernorth is actively engaging with providers and seeking their input in defining the best metrics for assessing treatment effectiveness. By building collaborations with key providers committed to quality outcomes, Evernorth aims to develop interventions that benefit patients, clients, and mental health professionals alike.

Dr. Doug Nemecek, Chief Medical Officer of Behavioral Health at Evernorth, emphasizes the importance of aligning on treatment measurements that can drive improvements. The goal is to create a program that not only delivers best-in-class clinical outcomes but also promotes multi-stakeholder affordability.

4. Collaborating with Providers for Standardized Metrics

Evernorth recognizes the need for standardized metrics to ensure consistency in care delivery and measurement across the behavioral health network. By collaborating with over 44,000 providers in the initial launch of the program, Evernorth aims to establish a broad agreement on these metrics. The providers include behavioral health coaches, therapists, and prescribers who specialize in various mental health conditions, including anxiety, depression, sleep disorders, and substance use disorders.

The collaborative approach with providers allows for a diverse range of perspectives and expertise to be incorporated into the program. As Evernorth engages with these providers, additional metrics will be identified and added to the program over time. This iterative process ensures that the program remains dynamic and aligned with the evolving needs of patients and providers.

5. The Initial Launch and Expansion Plans

Evernorth’s measurement-based care program is set to have an initial launch with over 44,000 participating providers. However, this is just the beginning, as Evernorth plans to expand the program over time. By involving a significant number of providers from the outset, Evernorth aims to establish a strong foundation for the program and gather valuable insights into its effectiveness.

The expansion of the program will allow Evernorth to reach more patients and providers, ultimately improving access to high-quality care. The program’s scalability demonstrates Evernorth’s commitment to making a lasting impact on the behavioral health landscape.

6. Key Metrics for the Program

Evernorth has identified several key metrics that will drive the measurement-based care program’s success. These metrics are designed to ensure quick access to care, avoidance of higher levels of care, and cost-of-care savings. By tracking these metrics, Evernorth aims to collaborate with providers to improve care outcomes and enhance the overall patient experience.

Some of the key metrics identified by Evernorth include:

• Time taken for patients to receive an appointment
• Reduction in the need for higher levels of care
• Total cost-of-care savings

These metrics provide a holistic view of the program’s impact and enable both payers and providers to gain valuable insights into access and outcomes.

7. Minimizing Administrative Burdens for Providers

One of the primary goals of Evernorth’s measurement-based care program is to alleviate the administrative burdens faced by providers. Rather than focusing on paperwork, Evernorth aims to enable providers to prioritize patient care. By incorporating measurement in a way that minimizes administrative burdens, providers can dedicate more time and resources to delivering high-quality care.

Evernorth is committed to streamlining administrative processes by implementing shared metrics throughout the customer journey. This approach ensures that the collection of data and measurement occur seamlessly, reducing the administrative workload for providers while maximizing the benefits for both providers and patients.

8. The Benefits of Embedding Shared Metrics

Embedding shared metrics throughout the customer journey offers numerous benefits for both payers and providers. By collecting and analyzing data consistently, payers can gain valuable insights into access and outcomes. This information can inform decision-making processes, leading to more effective interventions and improved patient outcomes.

For providers, shared metrics offer a transparent and standardized approach to measuring the effectiveness of their interventions. This not only enhances the provider experience but also fosters trust and collaboration between payers and providers. By aligning on shared metrics, providers can work towards common goals with confidence, knowing that their efforts are contributing to improved patient outcomes.

9. About Evernorth Health Services

Evernorth Health Services is a leading provider of pharmacy, care, and benefits solutions aimed at improving health and increasing vitality. The company is committed to making the prediction, prevention, and treatment of illness and disease more accessible to millions of people. Evernorth’s capabilities are powered by its businesses, including Express Scripts, Express Scripts Pharmacy, Accredo, eviCore, and MDLIVE. Through these platforms and solutions, Evernorth moves individuals and organizations forward on their health journeys.

10. Conclusion

Evernorth’s introduction of an innovative behavioral health measurement-based care program marks a significant step towards improving patient outcomes and enhancing the provider experience. By collaborating with providers and establishing standardized metrics, Evernorth aims to drive consistency in care delivery and promote multi-stakeholder affordability. The initial launch of the program with over 44,000 providers, along with plans for expansion, demonstrates Evernorth’s commitment to making a lasting impact in the behavioral health landscape. Through this program, Evernorth is reinforcing its dedication to health, value, and the well-being of patients and providers alike.