Boulder Care and Umpqua Health Alliance Announce the Success of Their Value-Based Payment Arrangement

    PORTLAND, OR, October 10, 2023 /24-7PressRelease/ -- Boulder Care, a telehealth organization providing comprehensive care for substance use disorders, announced today it successfully met one-hundred percent of performance quality measures outlined in an innovative value-based payment arrangement (VBP) with Umpqua Health Alliance, a managed Medicaid insurer in Oregon.

As part of Boulder Care's commitment to leading the addiction medicine industry in clinical quality, the multi-market provider group is held accountable by health plan partners for achieving measurable patient outcomes: tying its own financial success directly to the success of payor customers and their members.

Boulder Care executed one such innovative VBP arrangement with Umpqua Health Alliance last year: linking reimbursement to a set of impactful patient outcomes for Umpqua Health Alliance members in treatment with Boulder Care for opioid and/or alcohol use disorders.

Together, Boulder and Umpqua Health Alliance developed a value-based payment framework for 34,000 Umpqua Health Alliance members intended to increase access to timely, evidence-based addiction treatment and avoid adverse outcomes – in turn, reducing costs to the Medicaid plan. Under this arrangement, Boulder agreed to put a portion of its reimbursement for medical services "at risk" until quality performance metrics were achieved over the relevant time period.

Data confirm that Boulder Care met or exceeded all of these metrics, qualifying for receipt of the full performance-based payment.

"Boulder Care is thrilled to recognize this milestone in our work to bring value-based care to Medicaid members across the US who deserve high-quality SUD care. We are so proud of this collaboration with Umpqua Health Alliance to develop, measure, and contract around a set of shared standards for exceptional SUD treatment – and together, to realign financial incentives for shared success.

"When providers like us are rewarded for demonstrable outcomes, everyone wins: the patient gets excellent care, the provider can dedicate time and resources to each individual in ways traditional fee-for-service seldom allows, and the health plan reaps cost savings due to healthier, more engaged members. We are grateful to Umpqua Health Alliance for being a true partner in this new frontier for behavioral health innovation." (Stephanie Strong, CEO, Boulder Care).

Umpqua Health Alliance praised the VBP model, explaining: "Risk withhold is intended to incentivize providers to manage overall cost of services delivered to Umpqua Health Alliance members through efficiency and quality. 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." (Dr. Douglas Carr, Chief Medical Officer, Umpqua Health Alliance).

The performance measures include National Quality Forum metrics for high-quality care SUD care, related to:
--Initiation and Engagement of treatment for opioid, alcohol, or polysubstance use disorders
--Timely follow-up support after an Emergency Department visit
--Continuity of care for patients in Medication treatment for opioid use disorder (MOUD).

Across all of its patients, Boulder Care has unparalleled outcomes in retention and patient satisfaction. In a recent independently verified 12-month study, Boulder had 94% retention in care at 48 weeks: three times higher than the national standard for outpatient treatment – and a Net Promoter Score of 90. Purpose-built for value-based care, Boulder serves several thousand patients with SUD in partnerships with nearly 100 health plans.

About Boulder
Boulder Care is a digital clinic that offers long-term support and telehealth treatment for substance use – grounded in kindness, respect, and unconditional support. Dedicated Care Teams collaborate across medical, behavioral, and psychosocial dimensions to deliver evidence-based care and help patients work toward their unique recovery goals. Millions of people have access to Boulder Care through leading health plans, employers, and other partners. For more information, please visit www.boulder.care or contact us at [email protected].

About Umpqua Health Alliance
Umpqua Health Alliance is one of 16 coordinated care organizations (CCOs) in Oregon that has served members of the Oregon Health Plan since 2012. Umpqua Health Alliance connects more than 340,000 Douglas County OHP members to physical, behavioral, oral, and dental care through an integrated network of providers. Umpqua Health Alliance is managed through a locally-based board of directors and Community Advisory Council that ensures local healthcare needs are fully met.

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