Behavioral Health Provider Collaboration

Anthem launched a new value-based payment initiative for our large-volume behavioral health providers and substance use disorder (SUD) facilities serving commercial members. Anthem Behavioral Health Provider Collaboration is a pioneering venture with a mission to recognize—through reimbursement incentives—health care professionals and facilities that offer improved treatment outcomes and quality clinical care.

 

 

Value-based Payment Opportunity

 

The National Alliance Health Purchaser Group identified Anthem behavioral health value-based payment program as the industry leader among health care plans. There are three distinct recognition categories under this program:

 

  • SUD/Behavioral Health Facility
  • Behavioral Health Outpatient Provider
  • Medical/Behavioral Health Integration using one of three service models—fully integrated, co-located or coordinated

 

 

Participating Health Care Professionals

 

Our behavioral health value-based payment program leverages the Healthcare Effectiveness Data and Information Set (HEDIS®) to measure the quality of care that patients receive. Visit the HEDIS website to learn more about these measurement guidelines.

 

Current HEDIS measures for behavioral health clinical quality 

Integrated Behavioral Health Care

80% of people with a behavioral health disorder will visit a primary care provider at least once a year1.

Adults living with serious mental illness die on average 25 years earlier than other Americans, largely due to treatable medical conditions2.

30-50% of patient referrals from primary care to an outpatient behavioral health clinic do not make the first appointment3.

Integrated Behavioral Health Care Defined 

 

The Integration Framework 

 

 Medical/Behavioral Health Integration and Value-based Payment

 

Advancing Care Together 

 

APA Collaborative Care Model 

 

APA Training Opportunities in Integrated Care 

 

State Innovation Model (SIM) Grants 

Contact Us

 

For additional information or to ask questions, email the Behavioral Health Provider Collaboration team.

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Ready to become a provider in the Anthem network?

We look forward to working with you to provide quality service for our members.

 

Payments for services from a non-participating provider are generally sent to the member, except where federal or state mandates apply, or negotiated agreements are in place.

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