With reimbursement systems shifting from fee-for-service to value-based care, behavioral health providers need to adapt their business models in order to successfully navigate new payment environments. This requires being able to accurately calculate and track the cost of producing the outcomes that payers value in order to negotiate adequate reimbursement.
To assist behavioral health finance and accounting staff in preparing for the transition to value-based payment and care, the Delta Center hosted a series of webinar trainings, Focus on Behavioral Health: Understanding Your Costs in an Evolving Payment Environment. These webinars were facilitated by Capital Link, a national, non-profit organization that specializes in helping health centers improve operations and financial management.
Session 1: Focus on Behavioral Health: Cost Allocation – Getting the Basics Right
The first webinar in the series provided a detailed review of the methodology behavioral health providers should use for allocating costs in a fee-for-service accounting environment (direct, indirect, and overhead), and an introduction to how “costing” will differ for in a value-based system.
Session 2: Focus on Behavioral Health: Preparing Internal Systems for Gathering Cost Data
In the transition toward value-based payment, behavioral health providers must be able to accurately track, manage, and report their costs in new ways. But many face challenges in doing so because their accounting and other systems are not set up to capture cost data in a meaningful and flexible way. During this session, we provided insight into the ways your organization can set up its chart of accounts, practice management systems/electronic health records, and HR/payroll systems to facilitate an accurate understanding of cost.
Session 3: Focus on Behavioral Health: Cost Allocation Methodology for Value-Based Payment Systems
In this session, we discussed how to identify and calculate costs in a value-based reimbursement environment. Beginning with a high-level overview of value-based reimbursement concepts, we described the methodologies for identifying costs related to care pathways and clinical outcomes, and provided examples that translate this effort into identifiable costs.
Session 4: Focus on Behavioral Health: Utilizing Cost Data to Drive Programmatic Change
During the final webinar, we reviewed the key takeaways from the first three sessions and applied these concepts to several scenarios in which behavioral health providers seek to understand their costs in an evolving reimbursement environment. We focused on how to model costs related to these scenarios and emphasized the use of this information for decision-making, negotiating with payers and guiding programmatic change.