Whether your organization’s behavioral
health benefit is “carved in”
or “carved out”, we can help.
Plan Design: Through behavioral health consulting,
we can help you decide whether a “carve
out” or a “carve in” makes
most sense for you organization. We can
compare your plan design to a variety of
options that are tied to specific goals
and objectives and make design recommendations
that are compliant with State and Federal
Parity Legislation.
Price/Fees: (if “carved out”)
We can compare your current pricing to market
ASO rates based on recent ASO benchmarking
data. If fees are above market, we can help
you negotiate a fee reduction without impacting
negatively on outcomes. Additionally, our
behavioral health consulting database includes
provider fees for all levels of care, which
we can compare to the provider rates that
your vendor has negotiated with service
providers.
Performance: Through behavioral health
consulting, we can conduct an evaluation
and audit that compares performance
and utilization data delivered by your vendor
to our database of key performance metrics
based on industry standards and best practices.
For example, we can evaluate the extent
to which your vendor has developed a provider
network using clinicians that practice evidence-based
care and the outcome methodology used by
your vendor to show value. We can provide
you with benchmark data on key metrics such
as admission rates, average length of stay,
outpatient visits per 1000 and outpatient
visits utilized per course of treatment.
We can evaluate the extent to which your
vendor makes use of alternatives to inpatient
care. We can also evaluate your vendor’s
reporting template to identify any gaps
in reporting of aggregate information that
would be useful to you.
Through our Behavioral Health Consulting,
we have been able to identify and resolve
gaps in service delivering and reporting
that have added significant value to our
customers’ behavioral care management
services.
We can also develop and execute an RFP
process to help you identify the best
in class vendor that meets or exceeds your
service requirements.
In most cases, delivering direct savings
for our customers pays for our fees.
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