Case rate program in tri-state area

Continuum Behavioral Healthcare Corporation, the New York-based managed care provider of Merit Behavioral Care Corporation, is implementing a new case rate reimbursement program for providers in the New York, New Jersey, and Connecticut tri-state area.

A case rate system reimburses based on an episode of care, as opposed to the traditional fee-for-service system, which reimburses on a per-visit basis, explains John Kastan, PhD, Continuum’s director of New York operations.

"This system encourages efficiency in terms of care," he says. "Ideally, treatment will neither be extended too long nor be terminated too soon. It also provides provider flexibility to design the treatment plan and modify it without continual request changes, so we cut down on the micromanagement we see so often in managed care. In exchange for that, we have to be very careful in our selection of providers and institute the right kind of accountability system."

Merit currently provides behavioral care services to more than 1,000 clients across the country.