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What is the role of Tufts Health Plan?

Tufts Health Plan is seeking to identify high value providers and to promote a collaborative relationship between practitioners and their patients. Practitioners who routinely seek structured feedback from their patients and who measure their clinical results are best positioned to define their value. Tufts Health Plan is helping to underwrite the cost to select providers to implement feedback informed treatment into their practice so that more practitioners are positioned to define their value.

The survey tools available to practitioners to use with their patients are developed and managed by CCI. The information submitted using the tools is submitted to CCI. The clinical models providing feedback to clinicians about high risk or low risk cases are developed and managed by CCI. CCI's tools and processes are based on scientific research, data, and evidence. Tufts Health Plan is making this available thru CCI, a third party, to select providers.

From the health plan's point of view, the availability of providers with practice-based evidence of effectiveness and value has a number of benefits.

* Practitioners who adhere to a feedback-informed approach to therapy
  • Are optimizing the likelihood that members at high risk remain engaged in treatment
  • Are allocating treatment resources to the members most in need
  • Tend to improve their effectiveness over time
* By being able to quantify the value of behavioral health benefits covered by the plan, Tufts Health Plan aims to
  • Provide evidence to employers and other stakeholders of the benefits of behavioral health services
  • Demonstrate the effectiveness of the providers in its network
  • Define the value obtained under coverage offered by the plan

As the sponsor of the service Tufts Health Plan does have access to the data that participating clinicians submit to CCI. The data is not identifiable at the member level but is identifiable at the treating clinician level. Tufts Health Plan intends to use information gathered from the pilot project to demonstrate the value and effectiveness of the behavioral health benefits covered under the plan. In the future this information may also be used to reward the practitioners who obrtain the best results and deliver the most value, and to identify opportunities to improve the cost-effectiveness and quality of benefit-covered services.

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