Insurance Partners and Health Systems/ACOs
Building Collaborative Relationships
As part of our mission of Changing People’s Lives®, we collaborate with health systems, ACOs, and insurance companies. This collaboration improves quality, enhances access to meet behavioral health needs, and eliminates unnecessary expense by coordinating care.
We believe that collaborative relationships with insurance companies are key to improving access to cost-effective behavioral health services. Over 50 million Americans suffer from mental illness, but 40% do not receive necessary treatment. Of the 25 million Americans suffering from addiction, only 10% receive necessary treatment.
In addition to improving the quality of life, providing access to appropriate behavioral health services dramatically impacts the overall cost of medical care. We know that spending on quality behavioral health services decreases the overall medical spend, with a ROI of up to 6:1 (The Collaborative Care Model, Health Home Resource Center, May 2013). Effective behavioral health care can lead to decreased medical admissions, decreased behavioral health admissions, decreased readmissions, decreased emergency department visits, decreased polypharmacy, and decreased expensive complications of addiction such as hepatitis, HIV, and endocarditis.
Springstone collaborates with insurance companies in the following ways:
- Comprehensive Quality Programs: collaborate with you to close gaps in care and help meet your quality metrics including HEDIS. Utilize outcomes measures to monitor effectiveness.
- Access: use our joint analytics capabilities to identify areas lacking access to behavioral health services and implement strategies including tele-health, new outpatient locations, and expanded hours of service to meet the needs of beneficiaries.
- Emergency Department Avoidance Program: utilize our 24/7/365 behavioral health call center to provide assessments, coordinate care, and send patients directly to the appropriate level of care.
- Initiatives to Decrease Readmissions: our continuum of care ensures that patients transition to the appropriate level of care, and avoid unnecessary readmissions. Our call center and utilization management teams will facilitate timely scheduling of follow-up care and elimination of gaps in care.
- Innovative Bundled Payment Program for Opioid Addiction: work with payers to combat the national opioid epidemic through progressive programs that enhance quality care and strengthen communities.
- Outpatient Medication Management Programs: most areas of the country suffer from a lack of access to outpatient medication management services. We provide convenient appointments in a timely fashion, which will improve satisfaction, decrease emergency department visits, and decrease readmissions.
- Tele-Health Services: our tele-health solutions are structured to bring behavioral health services to underserved and rural areas, primary care settings, and emergency departments in a cost effective fashion.
- Value Based Solutions: our continuum of care and partnerships with health systems and ACOs provides a platform to deliver value based behavioral health services.
We partner with health systems and ACOs in numerous ways to collaborate and coordinate care. Our partnerships take many forms including:
- Remote Tele-Assessments Services: we provide assessment for behavioral health patients and medical/surgical patients with behavioral comorbidities. Services are available for your emergency departments, inpatient hospital units, and outpatient locations.
- On-Site Mobile Assessment Teams: we travel to your emergency departments or other access points to assess behavioral health patients.
- Call Center Services: our comprehensive state-of-the-art behavioral health call center is staffed by trained professionals who will coordinate care and facilitate dispositions for your behavioral health patients. We also provide a live chat option, and will meet your needs with customized protocols and dedicated unique phone numbers.
- Collaborative Care Agreements: formal customized agreements that are structured to meet the needs of our partners. Areas of collaboration include quality initiatives, community outreach, tele-assessment services, mobile assessment services, call center services, psychiatrist coverage, opiate addiction treatment initiatives, and preferred provider care coordination.
- Joint Venture Agreements: we partner through JVs with like-minded organizations to improve access to behavioral health services. Options include:
- JV Behavioral Health Facilities: our analytics team has partnered with a best-in-class site selection/consumer analytics company to develop a proprietary model that will identify the best location in your market to build a new state-of-the-art behavioral facility. Our development and construction team will secure all necessary zoning, permits and regulatory approval and build the facility in as little as 14 months. We specialize in new construction, but can also renovate existing buildings or convert under-utilized inpatient units to behavioral health beds.
- JV Behavioral Health Outpatient Locations: using our proprietary site selection/consumer analytics model, we will work with you to identify the best outpatient locations in your market. Our development and construction team will secure all necessary zoning, permits, and regulatory approval and build-out the space in as little as 120 days.
- Comprehensive JV to Manage the Entire Behavioral Health Continuum of Care: our team will work with your organization to perform a needs analysis and develop a comprehensive plan for a turnkey solution to meet your behavioral health services goals. This can include construction of new inpatient and/or outpatient facilities, renovation of existing space to increase behavioral health capacity, tele-assessment and tele-health services, employment of psychiatrists and other behavioral health specialists, call center and case management services, and comprehensive management of all aspect of behavioral health.
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