We’re already seeing partnership around avoidable ED utilization, better pregnancy outcomes, and improved access to care including behavioral health.
For maternal health, there is tremendous variation in the experience, quality, and cost for services. Population-based payment gives providers freedom to invest in, for example, birth doulas to advocate on the mother’s behalf and reduce unnecessary utilization of expensive drugs and services.
Unmet behavioral health need was a challenge before the pandemic and only has grown since. And true value-based payment justifies provider investment in psychosocial supports necessary to avoid acute utilization, like a dedicated behavioral health care manager.
There are already clear incentives for providers, plans, and employers to partner in these areas whether the metric of success is cost of care, quality of care, productivity, and/or absenteeism.