Wertorientierter Einkauf (VBP)

It is always the goal of Carelon to assist our members in achieving the best possible chance at recovery. One of the ways we do this is by collaborating with providers and appropriately rewarding them for delivering high quality and cost efficient care to Carelon members. Over the last several years, Pennsylvania’s Department of Human Services (DHS) has prompted Behavioral Health Managed Care Organizations (BH-MCOs) to move away from traditional fee-for-service reimbursement models that reward providers for quantity of services over quality of care and enter into value based payment (VBP) arrangements that will improve patient outcomes and lower the cost of care. Carelon has continued to support its network providers with this transition while implementing the state’s VBP initiatives. As a provider, you may already participate in a VBP program Carelon offers or will have the opportunity to join one in the future. To ensure that all providers participating in a VBP model have the necessary tools to succeed in these programs, Carelon delivers education, data and the support of dedicated staff, and also enables providers to share best practices.

To Participate In One Of Carelon’s Value Based Purchasing Programs Or Receive Additional Information

  • Please contact Napali Bridgelall, Payment Innovation Manager, at Napali.Bridgelall@carelon.com. For questions about our Provider Quality Management Program, please contact Laura Karoffa, Associate Director Clinical Programs/Provider Quality, at Laura.Karoffa@carelon.com. For general Provider Relations questions, please contact Lisa Ciccarelli, Provider Relations Director, at Lisa.Ciccarelli@carelon.com.

Ressourcen des Pennsylvania Department of Human Services

Carelon Health Of Pennsylvania Resources