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Platinum Recognition for Facility-Based Programs

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Platinum Facility Recognition Program
PLATINUM PROGRAM DATA IS NOW AVAILABLE TO VIEW

To view your data go to:  Login to Secure Transactions >> Provider Reports >> Annual Facility Scorecard

SPECIAL NOTE TO FACILITIES AT ALL LEVELS OF CARE

It's critically important that you inform Optum at the time of member discharge or step-down to a lower level of care. Failure to do so will result in delays of reimbursement, and very possibly denial of submitted claims. Reporting member discharge is consistent for all levels of  care, including acute inpatient, residential and partial hospitalization. Additionally, facilities may be contacted by Optum for intervention or review on an as needed basis, for admissions demonstrating significant complexity and/or recent chronicity.  

PLATINUM PROGRAM RECOGNITION REVIEWS ARE DONE ON AN ANNUAL BASIS

Data on all Platinum programs is completed on a 12-month look-back cycle each spring. When the data run is completed, Optum will notify facilities of their status via letter instructing them to go to Provider Express to view their data.

Platinum Recogntion for Facility-based Programs

The Platinum program provides an evaluation of facility performance and is based on an annual, data-driven assessment. We use benchmarks that are developed from similar patient cohorts by Level of Care, Condition Category, and Product Type.

Platinum allows for more specific comparisons of facility-based behavioral health programs. We will identify Platinum programs within the three condition categories: General Mental Health, Substance Use Disorders and Eating Disorders.  And in addition, we monitor performance separately in three levels of care: Inpatient, Residential, and Partial Hospitalization.

Top Performing
programs will be
designated as Platinum
  Facility program admissions
will be evaluated in condition
categories
  Facility program performance
will be evaluated separately
by level of care
 

 

The purpose of Platinum is to recognize and reward facilities for delivering effective and efficient care

Platinum endeavors to evaluate facilities based upon trends in health care, as well as the feedback we garner from our network providers and facilities. Listening to what you have to say presents Optum with a fantastic opportunity to incorporate your thoughts and innovations into an evaluation program that is better for you, our members and the behavioral health community at large. Using unbiased data that is quantified and compared to regional program benchmarks, Platinum excels at utilizing data to measure variations in practice patterns, which drive increased costs and poor clinical outcomes.

Facility-Based BehavioralHealth ProgramAchievement

Platinum status has its benefits

  • Identifying, recognizing and rewarding facility-based programs that provide effective and efficient care for our members
  • Develop and promote transparency of effectiveness and efficiency metrics
  • Monitor metrics for continuous program improvement
  • Delivery of clinically relevant and actionable metrics
  • Distinguish between specific diagnostic categories, levels of care and product type 

For a more in-depth explanation of the Platinum Recognition Program, please explore the links below. 

For questions or more information about Platinum or your current facility ranking, please contact us at platinumprogram@optum.com.

Platinum Team Members
Alecia Lamb MHA, MS, MA, LPC, LCPC
Provider Enablement
alecia.deutch@optum.com
(314) 592-3790
Patsy Reed, MA, LPCC, LADC
Behavioral Clinical Program Manager
Provider Enablement
Central and Northeast Regions
patrice.a.reed@optum.com
(952) 703-4469
Trisha Stewart BSN, RN
Behavioral Clinical Program Manager
Provider Enablement
Southeast and West Regions
patricia.a.stewart15@optum.com
(763) 361-6015
Platinum Facility Recognition Program