Amita Health COO: Behavioral Health Providers Who Can’t Quantify the Impact of Care Will Struggle in Value-Based Care World

Amita Health’s behavioral health division adopted measurement-based care because it wanted to understand how and if the care it offered made a difference in the health of its patients.

Jason Washburn, a clinical psychologist at Northwestern University and a consultant for Amita Health Behavioral Medicine, said about 15 years ago the Chicago-based health care system started to develop a comprehensive clinical outcome system that would use the best clinically validated assessments to gather data on the impact of the care provided to patients.

Planning out the system was the easy part, Washburn said on a recent webinar produced by Owl Insights Inc., branded as Owl. Actually gathering and crunching the data was the hard part. 

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Amita Health started trying to measure the impact of its behavioral health care using pen-and-paper forms and document scanning technology. That eventually also included using SQL databases. But the clinicians who were meant to benefit from analyzing clinical outcomes had questions for the data that quickly exceeded Amita Health’s capabilities to answer.

“We eventually realized that you can have the best measures in the world, you can have the best intentions in the world, but you need a process that works,” Washburn said.

The full implementation of analyzing clinical data in real-time to inform clinical and operational practices — or measurement-based care — didn’t come into reality until Amita Health teamed with Owl, a Portland, Oregon-based health care technology company that provides automated patient-reported data collection and analysis services. 

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Chris Novak, vice president and chief operating officer of behavioral medicine, said on the webinar that following the implementation of Owl the system has been able to get insights into care quality and its consistency across several settings. Amita’s behavioral health line includes 638 inpatient beds in 12 of the system’s 19 hospitals, three residential treatment centers and 52 outpatient locations. 

“So often in behavioral health, we have a very subjective view of things and not necessarily objective, concrete data to be able to show what we’re doing is effective and actually providing an impact to the patients we serve,” Novak said.

In recent days, Novak said that Owl-enabled measurement-based care allows for greater accuracy in initial assessments, which he said are vital to a patient’s success with treatment. This includes getting matched with the best provider for that patient, an element of care customization that is important in cases of severe behavioral health need. 

How Amita Health uses measurement-based outcomes and the shift to value-based care

The access to the right technology gives Amita Health real-time data to benchmark the success of its care delivery across the system. This helps assure quality across the unified treatment approach that Amita applies in all its care settings.

At the operational level, Novak said that Amita Health has been able to validate its COVD-inspired telehealth practices.

“The magic question ‘Is what we’re doing effective and actually making a difference?’” Novak said. “We had that same question as we moved into a virtual model. We’re able to look at that real-time data to understand and actually demonstrate that, yes indeed, our virtual-based programs are having just as much of clinical effectiveness in that environment as it is in the traditional in-person model that we’re so used to.”

Measurement-based care has also helped Amita Health’s clinicians demonstrate the effectiveness of care to patients. Novak said that clinicians are able to have more collaborative therapeutic alliances with their patients when they are able to show how the patient’s health has changed over time.

Demonstrating changes in health metrics over time is at the heart of value-based care, an insurance reimbursement model that’s based on the care outcomes that patients experience rather than pay fees for each service.

“It’s (value-based care) been something that I think people have tried to grapple with,” Novak said. “How do we truly measure and ensure that the treatments that we’re providing have effective and demonstratable clinical outcomes?”

Value-based care is a growing trend within the behavioral health sector. Executives in the space generally see it as a key opportunity for their organizations. Leading health insurance plans are pushing toward greater implementation of value-based care with behavioral health providers. However, technology adoption is a major limiter in the industry’s ability to move toward value-based care.

Other physical health care segments have seen wider adoption of value-based care models because those segments have specific tools that measure the health of a person’s body, something that behavioral health lacks, Novak said.

The key to moving toward a value-based care model in behavioral health is measurement-based care that’s enabled by robust data collection through something like an Owl platform. 

“If you can’t quantify your clinical programs and the effectiveness of those programs, it’s going to be very hard to enter into a value-based care world whenever that time point is that we truly get to that arrangement,” Novak said.

Outside of the latest trends in payment models, Washburn said that the health care sector, on the whole, will likely face higher degrees of scrutiny in the future. Health care spending in the U.S. increased by 9.7% to $4.1 trillion in 2020, or about 20% of the nation’s gross domestic product, according to an analysis by the Centers for Medicare & Medicaid Services. The same analysis predicts that national health care spending will increase 51% to $6.2 trillion by 2028.

“Even if you’re not living in a value-based world right now, and even if that’s not on your horizon, accountability certainly is,” Washburn said. “We are not in an age anymore where we can continue to provide treatment without showing that it’s effective.”

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