DURHAM, N.C. – Blue Cross and Blue Shield of North Carolina (Blue Cross NC) is bringing value-based payments to its network of behavioral health providers, giving patients better access to high-quality, better-coordinated care for mental health and substance use disorders. The changes are among the first of their kind among health plans, which traditionally have treated behavioral health separately from physical health.
On Jan. 1, 2020, Blue Cross NC launched Blue Premier Behavioral Health to reward behavioral health providers with higher payments for achieving improvements in quality measures. Blue Cross NC is collaborating with Quartet Health, a health care technology and services company working to improve the lives of people with mental health conditions, to measure the quality of care patients receive and better compensate providers for improving patients’ health.
The new approach to payment builds on efforts Blue Cross NC began in 2019 to better integrate behavioral health with physical health and to transform health care through value-based payments. It also integrates with Blue Premier, the company’s value-based care program that holds providers and Blue Cross NC jointly accountable for improving care and lowering costs.
“It’s time for our health care 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 head of behavioral health. “Blue Premier Behavioral Health will expand access, improve coordination with primary care and help achieve better health outcomes.”
Blue Cross NC last year began offering Quartet’s services to primary care and mental health providers free of charge. Through Quartet, doctors can easily recommend patients for care with mental health providers who best meet their needs. The secure, HIPAA-compliant platform enables providers to collaborate for the care and support their patients need.
“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 health care they deserve,” said David Wennberg, MD, MPH, CEO of Quartet. “Our technology will help people get the best mental health care 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 health is health care.”
Value-based payments are one way Blue Cross NC is addressing challenges in behavioral health. Milliman, a health care consulting firm, has found that it’s becoming more difficult for patients to find access to affordable mental health and substance use disorder treatment.1 Reasons include lack of participation in health plan networks by behavioral health providers as well as a shortage of behavioral health providers.
Blue Cross NC is actively inviting behavioral health providers to participate in Blue Premier Behavioral Health. Independent, outpatient behavioral health providers who serve members of Blue Cross NC commercial (non-government) plans may enroll by May 31, 2020, and begin using the Quartet platform to be eligible for the program.
About Blue Cross and Blue Shield of North Carolina:
Blue Cross and Blue Shield of North Carolina (Blue Cross NC) improves the health and well-being of our customers and communities by providing innovative health care products, services and information to more than 3.9 million members, including approximately 1.1 million served on behalf of other Blue Plans. Since 1933, we have worked to make North Carolina a better place to live through our support of community organizations, programs and events that promote good health. Blue Cross and Blue Shield of North Carolina is an independent licensee of the Blue Cross and Blue Shield Association. Visit Blue Cross NC online at bluecrossnc.com. All other marks are the property of their respective owners.
1 “Addiction and Mental Health vs. Physical Health: Widening Disparities in Network Use and Provider Reimbursement,” Milliman Research Report, November 2019