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Quartet Health, Blue Cross NC Collaborate on Value-Based Care Payment Model for Mental Health

by Jasmine Pennic 01/28/2020 Leave a Comment

Centene Leads $60M Round for Behavioral Health Platform Quartet

– Mental health technology company Quartet Health announced a new technology that helps install a value-based quality measurement system for mental healthcare.

– Achieved in collaboration with Blue Cross of North Carolina — an insurer known for being on the forefront of improving mental health access and a tech leader — Quartet and BCNC are introducing it as the market’s first and will serve as a framework for all insurer adoption. 

Quartet Health, an innovative mental healthcare technology, and services company, today announced a new effort to improve the quality of mental healthcare that patients receive. As part of the collaboration, Quartet, and payer Blue Cross and Blue Shield of North Carolina (Blue Cross NC) are collaborating on a new effort that will enable Blue Cross NC’s value-based payment model for behavioral healthcare. The aim of the collaboration is to help ensure people are getting high-quality mental healthcare that meets their needs in a timely manner while improving efficiency, performance, and patient health outcomes.  

The Underlying Impact

Nearly one in four people in America experience a mental health condition, yet more than half don’t get the treatment or support they need. A recent Milliman report found that it’s becoming more difficult for patients to find access to affordable mental health and substance use disorder treatment, both because of a shortage of mental health providers and because many don’t participate in a health plan networks. Many people face the problem of ghost networks when looking for mental healthcare covered by their insurance. For far too many people, mental healthcare remains out of reach, costly, and stigmatized. This collaboration is the first step in a systematic shift in the way that patients experience mental health, the way that mental health providers offer care, and the way that health insurers cover the cost of mental health services.

The recent shift to an outcomes-based healthcare system has focused almost entirely on physical health. Traditionally, it has also been harder to track what good mental healthcare is, and the standard of care has never been consistently documented. The HITECH Act of 2009 and ensuing Meaningful Use incentive payments created the technological framework and incentive structure for collecting and sharing data; however, it left out many mental health providers, including therapists and social workers, who have largely not been eligible for value-based payment programs.

Improve Access to Mental Healthcare and Patient Health Outcomes

Together, Quartet and Blue Cross NC are combining their unique assets to measure the quality of care patients receive, and create incentives to providers for improved patient access to in-network care, collaboration among providers, and improved patient health outcomes. Quartet’s technology platform provides the data-driven insights and technology infrastructure to measure and support the delivery of high-quality mental healthcare; Blue Cross NC provides the payment model with incentives to recognize and compensate behavioral healthcare providers for high-quality care through a new value-based arrangement, Blue Premier Behavioral Health. This effort can lead to improved health and lower total cost of care.

Quartet provides the strategy, insight, and infrastructure to measure quality. Blue Cross NC’s value-based payment model will reward mental health providers with incentive payments for achieving improvements and meeting benchmarks in quality measures. Eligible providers will use Quartet’s technology to support improved patient care, as well as enable data collection and measurement of quality outcomes. Through this work, Quartet will be able to better match patients to providers who meet their clinical needs.

“It’s time for our healthcare system to treat the patient as one person, not as someone with physical health needs and someone with behavioral health needs,” said Kate Hobbs Knutson, MD, Blue Cross NC chief of behavioral health. “Blue Premier Behavioral Health will expand access, improve coordination with primary care and help achieve better health outcomes.”

Roll-Out Timeline

Quartet is beginning this work with Blue Cross NC, and will work with additional health plans to roll out value-based mental healthcare across the country. 

“There’s no standard of care for mental health in America and Quartet is ready to change that. It’s time that we listen to patients and ensure that they can get the high-quality mental healthcare they deserve,” said David Wennberg, MD, MPH, CEO of Quartet. “Our technology will help people get the right mental healthcare for their needs, and allow mental health providers to be recognized and rewarded for improving patients’ health. This work acknowledges what we’ve long known: mental healthcare is healthcare.”

Quartet Background

Navigating mental healthcare can be difficult and confusing for both patients and providers. Quartet is changing this. Through Quartet, doctors and care managers can easily recommend patients for care; Quartet then works with their patients to connect them with resources and a mental healthcare provider who best meets their needs. This work is supported by Quartet’s secure technology that allows physical and mental health providers to connect about their patients’ health and work together to get them the care and support they need.

Quartet works with health plans across the country, including Blue Cross NC, to make it easier for people to get high-quality mental healthcare. With thousands of healthcare providers in North Carolina participating with Quartet since launching in 2019, Blue Cross NC and Quartet are uniquely positioned to lead this work, and in doing so, evaluate quality in mental healthcare as part of a larger value-based reimbursement healthcare approach.

“The only way to achieve true parity in mental healthcare is to make it easier for people to access high-quality care,” said former Congressman Patrick J. Kennedy, founder of The Kennedy Forum. “The work that Quartet and Blue Cross Blue Shield of North Carolina are doing to offer value-based payments for providers is critical. Those with mental health and substance use disorders should not have to endure a separate and unequal system of care.”

RELATED:   Net Health Acquires Post-Acute Analytics Platform PointRight – M&A

Tagged With: healthcare technology, hitech, MD, Meaningful Use, Mental Health, Mental Healthcare, model, Patient Access, Premier, Value-Based Care

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