Long-Term Value-Based Payment Model for Addiction Recovery Offers Holistic Chronic Care Management
NEW YORK–(BUSINESS WIRE)–Remedy, America’s leading episodes of care company, announced today that it is supporting the implementation and management of several initial demonstration pilots of the Addiction Recovery Medical Home (ARMH) Alternative Payment Model. The program, designed by The Alliance for Addiction Payment Reform (Alliance), aims to intervene early and help more people recover from addiction by establishing a comprehensive, sustained solution that offers coordinated care and holistic, long-term management of Substance Use Disorders.
The ARMH pilots and other value-based models being supported by the Alliance are being launched in several markets across the country including Connecticut, Kentucky, North Carolina, Tennessee, Texas, Washington, DC and Utah.
“An episode of care-based model for addiction recovery creates a wholesale, top-to-bottom reordering of the way healthcare is delivered, measured and paid for,” said François de Brantes, SVP of commercial business lines for Remedy. “Substance use services historically have been delivered in short-term and fragmented settings which are inherently more expensive and produce poor outcomes. Through our work with the Alliance, we are transforming the way conditions like addiction are treated by creating a chronic care model designed for long-term, sustainable impact.”
In addition to supporting participating payers and providers, Remedy, an authority on healthcare episode-based payment models, led the Alliance in developing and refining the comprehensive episode definition that will be used to implement the model in the pilot programs. The ARMH model is comprised of three phases of recovery over five years and establishes a broad continuum of care ranging from emergent and stabilizing acute-care settings to community-based services and recovery support. The payment model – which incorporates aspects of fee-for-service, episodes-of-care, quality-adjustments and shared-savings – promotes improved integration of treatment and recovery resources with corresponding financial incentives that benefit all stakeholders when the patient is well managed by a multi-disciplinary care team.
“Addiction is a chronic illness, but our healthcare system’s current response does not promote or incentivize long-term recovery and wellness,” said Greg Williams, a person in long-term recovery and a manager of the Alliance for Addiction Payment Reform from Third Horizon Strategies. “September is National Recovery Month and it is time for us to recognize that in order to shift the current trajectory of the overdose crisis we are going to have to transform from a volume-driven approach to one that embraces the value of long-term outcomes.”
The Alliance’s work is built on the foundational effort convened by Leavitt Partners, Facing Addiction with NCADD, and Third Horizon Strategies to develop an alternative payment model that could be commercialized and advanced through interested private sector parties. The ARMH model is unique in its scope and transformative approach to long-term community-based treatment and recovery from substance use disorders. The ARMH model was established with the initial goal of organizing care principles most germane to opioid use disorder and alcohol use disorder; however, the underlying principles traverse the substance spectrum and are intended to be sufficiently modular to support recovery in other contexts.
For more information about the ARMH model, please visit: www.incentivizerecovery.org.
About The Alliance for Addiction Payment Reform
Members of the Alliance include major commercial insurance plans, health care associations, health systems, and stakeholder groups. Since 2017, the Alliance convened clinical, addiction, information technology, primary care, social, regulatory, and policy expertise logging hundreds of hours of work group meetings, ratifying principles and outputs. Alliance Members include: American Hospital Association, Healthcare Financial Management Association, The Patient-Centered Primary Care Collaborative, The National Council on Behavioral Health, Duke Margolis Center for Health Policy, The Center on Addiction, The Kennedy Forum, Anthem, Amerihealth Caritas, CareSource, Superior HealthPlan, FAVOR Greenville, Remedy, Third Horizon Strategies, Nuvance Health, Appalachian Regional Health, Eleanor Health, WEconnect Health Management, Memphis Business Group on Health, HealthCare 21 Business Coalition, Face It Together, Capitol Decisions, eTransX. For more information about the work of the Alliance please visit: www.incentivizerecovery.org.
Remedy is America’s leading episodes of care company, which connects employers, insurance companies, and health care systems to deliver more cost-effective care and improved consumer experiences. Remedy delivers software and services enabling health care providers and health insurers to organize and finance health care around patient episodes of care. The Company’s bundled payment network serves Medicare and private insurers and manages over $9 billion of annual health spending. For more information, visit www.powerofremedy.com.