Boulder Care, a telehealth provider for substance use disorder, has met all of its performance quality measures in a value-based payment arrangement with a managed Medicaid insurer in Oregon.The contract was set up last year with Umpqua Health Alliance, tying reimbursement to a set of patient outcomes for UHA members in treatment with Boulder.

Boulder Care是一家针对物质使用障碍的远程医疗服务提供商，它与俄勒冈州的一家受管理的医疗补助保险公司以基于价值的支付安排满足了所有绩效质量措施。该合同去年与Umpqua Health Alliance建立，捆绑报销UHA成员用Boulder治疗的一组患者结果。

This marks the provider's first Medicaid contract eligible for performance payment and achieved, executives said.Working together, the partners developed a value-based payment framework for all 34,000 UHA members intended to increase access to timely, evidence-based addiction treatment while avoiding adverse outcomes.

高管表示，这标志着该提供商的第一份符合绩效支付和成就的医疗补助合同。合作伙伴共同为所有34000名UHA成员制定了基于价值的支付框架，旨在增加获得及时，循证成瘾治疗的机会，同时避免不良后果。

Boulder agreed to put a portion of its reimbursement for medical services at risk until quality performance metrics were achieved. Data confirm that Boulder met or exceeded its metrics, the company says, qualifying to receive the full performance-based payment. “Risk withhold is intended to incentivize providers to manage overall cost of services delivered to UHA members through efficiency and quality,” UHA Chief Medical Officer Douglas Carr, M.D., said in an announcement shown in advance to Fierce Healthcare.

Boulder同意将其医疗服务报销的一部分置于风险之中，直到达到质量绩效指标。数据证实，Boulder达到或超过了其指标，该公司表示，有资格获得基于绩效的全部付款。UHA首席医疗官道格拉斯·卡尔（Douglas Carr）博士在一份针对激烈医疗保健的公告中说：“风险扣留旨在激励医疗服务提供商通过效率和质量来管理向UHA成员提供的服务的总体成本。

“We were pleased to execute a value-based payment agreement with Boulder for the services they provide our members with substance use disorders and for their achievement of these metrics.”The measures included National Quality Forum metrics for high-quality substance use disorder care related to initiation and engagement of treatment, timely follow-up support after an emergency department visit and continuity of care for patients in medication treatment for opioid use disorder. The contract is part of Boulder’s broader mission to be held accountable by payers to achieve measurable patient outcomes, tying its fi.

“我们很高兴与Boulder签订基于价值的支付协议，为他们为成员提供物质使用障碍并实现这些指标。”这些措施包括国家质量论坛指标，用于与治疗的开始和参与有关的高质量物质使用障碍护理，在急诊科就诊后及时提供后续支持，并为阿片类药物使用障碍的药物治疗患者提供持续护理。该合同是Boulder更广泛使命的一部分，由付款人负责实现可衡量的患者结果，并将其与fi挂钩。

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Due to historically low reimbursement rates, many substance use disorder providers don’t accept Medicaid or are cash-pay only, per Strong, in effect “operating outside the system.” But in managed care arrangements, Medicaid plans are willing to reimburse for value. This makes substance use disorder treatment, particularly among digital-enabled providers, one of the most attractive new areas to execute value-based payment, Strong believes.Boulder has found commercial payers are quicker to adopt unique payment arrangements.

由于历史上较低的报销率，许多物质使用障碍提供者不接受医疗补助，或者仅仅是“在系统外运作”的现金支付。但是在管理式医疗安排中，医疗补助计划愿意偿还价值。强烈相信，这使得物质使用障碍治疗，特别是在数字服务提供商中，是执行基于价值支付的最具吸引力的新领域之一。Boulder发现商业付款人更快地采取独特的支付安排。

Medicaid takes longer to develop, Strong said, but is a more compelling area for both impact and shared savings. “There’s a lot of money for everyone to go around, and everybody wins—patients, providers and payers,” Strong said.Half of Boulder’s business is value-based care. It has grown the number of patients under value-based care by 10x year over year, according to Strong.

斯特朗说，医疗补助需要更长的时间才能发展，但对于影响力和共同储蓄来说，这是一个更有吸引力的领域。斯特朗说：“每个人都有很多钱可以走动，每个人都赢得患者，提供者和付款人的胜利。博尔德的一半业务是基于价值的护理。据Strong称，它使基于价值的护理患者人数逐年增加10倍。

If a payer isn’t ready to set up a value-based arrangement, Boulder starts with fee-for-service and looks at claims data together to get them up to value-based care eventually. “We’re not making decisions based on insurance type and we’re not bound by those same restrictions as a lot of traditional providers,” Strong said..

如果付款人还没有准备好建立基于价值的安排，Boulder将从服务费开始，一起查看索赔数据，最终使他们获得基于价值的护理。“我们不是根据保险类型做出决定，也不受与许多传统提供商相同的限制，”Strong说。。