Employers are Evaluating Doctors Based on Performance. Behavioral Healthcare is Next.

Walmart has become the first employer to use data to rate providers’ effectiveness and value. They evaluate how many patients a physician has cared for, or how much experience they have in a specific method of treatment, then they use the data to reduce costs wherever they can. Or, they mine data to deem providers “in network” or ‘out of network’, based on how effective that care is. Welcome to value-based care!

Now more than ever, it is important to specialize in a niche area of behavioral health AND be able to prove your programs are effective. Employers are using employee heath data to identify the best providers who offer the most complete care, at the lowest cost available. Your patients might be sent to other clinics across town – or even out of state – for specialized care that you are not able to deliver.

Being able to prove that your programs are effective is at the heart of value based care – but even more critical is that it’s at the heart of what you do for your clients. You’re not in the business of delivering a set number of hours to a client, but a set of mutually-agreed upon objectives, supports and clinical care that helps them reach that goal. And employers are watching.

Walmart is currently mining their data and profiling physician effectiveness across a large data set and using it for knee, spine and other major surgical procedures, even selecting providers who don’t recommend surgery for their clients (much to the dismay of some of the clients), but they’re saving money and reducing recovery time. And they’re not necessarily choosing the least costly programs, they also consider programs and clinicians that have the most experience and proven success with reduced recovery times and relapse rates. These same metrics will be applied to behavioral health care – long a ‘black box’ of funds paid into programs that delivered only hours, not outcomes.

Would you like to learn more about value-based care? Download a copy of our white paper, “Value-Based Payments in Behavioral Healthcare” to help you understand its importance and prepare your clinic for it. If insurers aren’t yet demanding it, the Walmart’s of the world are surely will.

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