BlueCross BlueShield Starts Region’s First Value-Based Payment Model for Behavioral Health Care in Partnership with Value Network

-Will Reward Leading Behavioral Health Providers for High-Quality, Coordinated Mental Health and Substance Use Disorder Treatment-

Buffalo, N.Y. – BlueCross BlueShield of Western New York today announced the region’s first behavioral health value-based payment agreement with Value Network — a behavioral health care collaborative with more than 100 area providers, including BestSelf Behavioral Health, Endeavor Health Services, Horizon Health Services, and Spectrum Health and Human Services. 

A value-based payment model focuses on quality of care, rewards health care providers for complete care management of their patients’ health and allows them to manage patients with more flexibility.  

BlueCross BlueShield is the first local health plan that will follow this approach, rewarding behavioral health providers for delivering quality mental health and substance use disorder treatment to its members. This follows the health plan’s roll out of Best Practice, a value-based approach for compensating primary care doctors in January 2017. 

“This is another step we’re taking to build a behavioral health care model that’s designed to effectively treat the whole person,” said Dr. Thomas Schenk, Senior Vice President, Chief Medical Officer, BlueCross BlueShield of Western New York. “BlueCross BlueShield of Western New York is proud to partner with the region’s leading behavioral health care providers to introduce the first payment model designed to directly enhance quality care for our members with mental health and/or substance use disorder diagnoses.” 

Value Network is comprised of 23 providers licensed through the New York State Office of Mental Health or New York State Office of Addiction Services and Supports (OASAS), as well as designated Home and Community Based Service Providers (HCBS). The Network has 65 other partners, including hospitals, primary care partners, prevention agencies, care-coordination entities, and other agencies that serve those who need assistance.

“Value Network is excited to partner with BlueCross BlueShield of Western New York on this exciting endeavor, which aligns perfectly with our agency mission to design and implement a health service delivery system that improves the quality, cost effectiveness, and overall experience of care in Western New York,” said Andrea J. Wanat, Vice President of Operations, Value Network. 

The local health plan has been a leader in raising awareness and supporting innovative treatment approaches for mental health and substance use disorder over the past decade, including launching a program with Horizon Health Corporations to support residential treatment for opioid use disorder in 2011; developing "Painkillers Kill," a campaign that began in 2014 that increased community awareness about the dangers of prescription painkiller abuse; supporting the launch in 2017 of Save the Michaels’ House of Hope for those recovering and their families; bringing the National Safety Council’s impactful exhibit on the opioid crisis to Canalside Buffalo in 2018; and donating $1 million to Erie County Medical Center’s (ECMC) Trauma Center/Emergency Department project to support behavioral health and detoxification services. 

“We are grateful for the collaborative partnership with BlueCross BlueShield that has resulted in this agreement. I know that working together we can continue to improve care in our community,” said Anne Constantino, CEO and President, Horizon Health Corporations and Value Network Board Vice President

BlueCross BlueShield also identified behavioral health as one of the key focus areas of the health focused grant program, Blue Fund. Launched in 2018, Blue Fund awarded grants to support Buffalo MATTERS, a program that immediately connects patients in emergency departments for opioid use with follow up appointments; Save the Michaels’ Court Treatment Program, a program that places and transports patients to treatment and provides recovery coaches to families of adjudicated users; Horizon’s new Family Training Center at Horizon Village, a program that provides expanded staff training and comprehensive after-care services for patients; Compeer Maryvale Leaders, a program that supports mental wellness mentoring in the Maryvale School District; and Directions: A Mobile Behavioral Health Project, a mobile van that provides behavioral health support to rural and underserved communities. 

Additionally, to help facilitate greater coordination between behavioral health treatment providers, primary care providers, and other needed treatment providers, BlueCross BlueShield expanded its team of qualified behavioral health professionals and transitioned all health management services internally in 2017. As a result, engagement with members seeking behavioral health treatment has increased nearly 120 percent. 

About BlueCross BlueShield of Western New York
BlueCross BlueShield of Western New York is a division of HealthNow New York Inc., one of New York’s leading health care companies that provides access to quality health care and solutions for members throughout Upstate New York. Since 1936, BlueCross BlueShield has helped millions of people gain access to health care. Today, we offer a full range of insured, self-insured, and government programs and services covering businesses, families, and individuals, as well as life and disability coverage, dental and vision plans and stop-loss coverage. The company contributes significantly to organizations that promote physical health, community health and our region’s health, and BlueCross BlueShield employees also raise and donate several hundred thousand dollars each year. Headquartered in Buffalo, NY, the company is an independent Licensee of the BlueCross BlueShield Association.

The Blue Cross Blue Shield Association is an association of 35 independent, locally operated Blue Cross and/or Blue Shield companies.