3 Ways to Transform Your Behavioral Health RCM Strategy to Value-Based Payment

Transitioning to value-based payment models in behavioral health requires a fresh approach to revenue cycle management. Traditional RCM practices, focused primarily on fee-for-service, often fall short of supporting the comprehensive and outcome-driven requirements of value-based care.

Behavioral health organizations must now adapt to new payment structures that prioritize quality outcomes, patient satisfaction, and risk management.

In this blog post, we have shared the three essential strategies for reshaping your RCM approach. By implementing these strategies, providers can optimize financial health for behavioral health practice.

Revenue Cycle Management in Behavioral Health

Revenue Cycle Management is the most important aspect of any healthcare practice, including behavioral health. It is the ideal for running a successful behavioral health practice. BH RCM Involves many steps which include pre-registration to claim submission and collection.

So, it involves all the steps from initial patient registration to final payment collection from patients. Because of this, it requires maximum efficiency. 

Poorly RCM strategies in Behavioral Health can ultimately affect the financial performance of the practice. Also, it can limit the providers from providing care for their clients.

Related: How Does RCM Outsourcing Improve Patient Care in Behavioral Health?

Value-Based Payment Models in Healthcare and Its Impact on RCM

Healthcare has adopted value-based payment in recent times. 

Due to the rise of value-based payment, the behavioral health RCM process has become more complex. Risk-based contracting necessitates that clinicians learn new skills such as: 

• Adhering to quality-based measures 
• Proving improved outcomes 
• Monitoring clinical performance at both the individual and population levels.

Electronic health records connected to behavioral healthcare revenue cycle solutions can greatly make it easier to adjust to this new payment landscape.

3 Ways to Transform Behavioral Health RCM Strategy to Value-Based Payment

1. Adopt Technology that Supports Value-Based Measures

• One of the key aspects is integrating behavioral health RCM with EHR. 
• Because it can configure data capture and alerts. 
• By informing providers that they must complete related data pieces, pre-built alerts can assist in meeting regulatory requirements, such as the Physician Quality Reporting Initiative. 
• The organization will have the most flexibility in responding to evolving quality measurements over time if it can automatically capture related data and create equivalent criteria by the payer. 
• By increasing the organization’s visibility of its performance and reducing the time and resources required to manage various data needs, technology capabilities in this area drive efficiency. 
• This prepares the organization for maximum success under value-based payment models.
• Another important element of a successful behavioral health RCM under fee-for-service contracts is accurate and comprehensive charge capture.
• By helping with documentation and coding, behavioral healthcare revenue cycle solutions should lower the likelihood of error in the charge capture procedure.

Related: Top 5 Benefits of Relying on Mental Health Billing Outsourcing Service

2. Enhance Measurement-Based Care and Outcome Tracking

• To guarantee that care treatments follow best practices, payment based on outcomes requires a precise evaluation of the client’s health. 
• This evaluation should take place both before and aftercare.
• Behavioral health professionals must have their clients’ full records at the point of care, along with workflows including screening and assessment tools.
• Facilitating referral management and moving towards evidence-based care planning is also crucial. 
• Clinicians will be better able to record progress and meet quality goals with the support of each of these features. 
• Clinicians will be better able to record progress and meet quality goals with the support of each of these features. 
• Seek out a system that enables the provider to safely transmit evaluations to clients on an as-needed basis, on a predetermined schedule, and throughout their first evaluation procedure.

3. Leverage Risk-Based Analytics for Better Decision-Making

• As the sector moves towards connecting clinical results and financial success, analytics and predictive skills are critical to behavioral healthcare revenue cycle solutions. 
• The ability to forecast income based on different risk scenarios, quantify the probability of events, and predict outcomes using historical data and machine learning algorithms is the foundation of risk stratification. 
• This data must also provide insights to guide clinical judgment and resource distribution.
• Risk stratification now requires effective population health management. 
• It also necessitates an understanding of the effects of social determinants of health (SDOH). 
• This is especially important for monitoring trends and overseeing care for high-risk populations.
• The Centers for Medicare and Medicaid Services’ 2024 final rule introduces a new HCPCS billing code. 
• This code covers an SDOH evaluation as an optional component of yearly wellness visits highlighting the significance of SDOH.
• Behavioral health professionals can better manage care for high-risk groups by monitoring SDOH data. 
• This practice helps them meet population health management standards.

Vozo Revenue Management Cycle Service for your Medical Practice

At Vozo, we understand your struggle in navigating through all the revenue cycle processes such as regulations, medical coding, and reimbursements. 

That’s why we bring the best cutting-edge service to optimize your revenue cycle management from start to finish. Here’s how Vozo can help you to transform your practice’s financial performance.

• Automated tools for error-free coding and faster reimbursements
• User-friendly billing to keep patients satisfied and payments flowing
• Robust data security and compliance protocols to protect your practice
• Detailed reporting and analytics for smarter business decisions
• Solutions that grow alongside your evolving needs

With Vozo RCM service, you can reduce the headaches associated with revenue cycle management and focus on what matters the most – quality patient healthcare delivery.

“Partner with Vozo RCM Service and unlock the full potential of your healthcare practice and maximize its revenue”.