In the world of recovery treatment, the concept of “high-quality care” can be nebulous. It means different things to different centers and clients, from comfortable amenities to specialized providers to a broad range of treatment options. Treatment centers often use their definition of quality to set themselves apart, promoting their location, credentials or approach to attract the right set of clients for their recovery community.
At Recovery Ways, we define quality differently. We don’t only focus on what we can provide for you while you are actively in our programs. We look beyond your treatment and ask how we can make a positive impact on the rest of your life. To us, high-quality care is measured by our patients’ outcomes — their successes, accomplishments and confidence in independent life after recovery treatment. When our clients go on to lead fulfilling, sober lives, we know that our treatment processes are achieving our standards of quality. And, when our clients run into obstacles to recovery, we don’t see failure; we ask how we can improve.
What is Optum Platinum Status?
Optum is an innovative insurance company that’s been working to redefine the parameters of high-quality care through a similar lens. Within the past few years, OPTUM has established a set of guidelines to measure clinical excellence based on addiction and mental health recovery centers’ patient outcomes. Optum has also partnered with a handful of recovery centers that meet their highest standards — Recovery Ways is proud to be among the 5% of treatment centers nationwide that meet Optum’s top Platinum Status designation.
Even if you don’t use Optum insurance, Platinum Status can help you or your own insurance provider understand whether a treatment center prioritizes long-term outcomes as well as more immediate measures of quality. When you see a center with Optum Platinum Status, it meets or exceeds important criteria that measure:
- Percent of patients readmitted to care within 30 days of discharge
- Percent of patients readmitted to care within 90 days of discharge
- Percent of patients who followed up with recommended aftercare within seven days of discharge
- Percent of patients who followed up with recommended aftercare within 30 days of discharge
- Costs per patient between three days before admission and 30 days post-discharge
- The average length of stay in treatment vs. the national average
When a recovery center scores well in each category, the result is treatment that:
- Sets clients up for success upon discharge
- Encourages continuing recovery habits on an independent basis
- Effectively follows up with clients after discharge
- Uses center resources efficiently for each patient
- Why We Need Better Outcome Measurements
Many recovery centers claim to have high rates of clients who go on to lead successful sober lives after treatment. These statistics are problematic, though — first, the way this information is collected often relies on phone or email contact, which is not always possible with every former client. If a center claims to have 80% patient success, for example, this might simply mean that 80% of the clients who answered a follow-up phone call reported that they had not relapsed. But this doesn’t account for the patients who didn’t answer the phone call, or the patients who had relapsed but were self-conscious about reporting it.
Optum’s guidelines go beyond these self-reported statistics, providing real evidence that patients are avoiding relapse, finding successes in sobriety and continuing with transitional care or independent aftercare.
Optum’s measurements are also raising the bar within the sphere of insurance coverage for addiction and mental health rehabilitation. Most insurance companies don’t actually consider a center’s outcomes or readmission rates when evaluating the center’s viability for coverage. Current practices focus more on the length of stay and average costs of care, which only speak to a center’s short-term cost-effectiveness. But in the long run, a patient who spends more on initial treatment but doesn’t relapse is more cost-effective than one who opts for the center with the lower cost of care and is readmitted within a few months. By measuring longer-term criteria, Optum not only improves its own coverage strategies but also improves its covered patients’ outcomes.
If you have insurance through Optum, the Platinum Status members of their network will be their top-suggested centers for care, followed by other network members that meet their standards for Gold, Silver or Bronze status. If you do not have Optum insurance, you can still benefit from the rankings the company provides for recovery centers nationwide. Their list of preferred treatment centers is available through their website, and you can ask your own insurance provider about coverage at Optum-rated facilities.
What Optum Platinum Means at Recovery Ways
When you’re considering Recovery Ways for addiction or mental health treatment, our Optum Platinum Status is a marker of measurable excellence. It means that we don’t just use subjective criteria to tout ourselves as a high-quality center; rather, we meet and exceed a real set of parameters that show how we give our clients a chance to succeed in a substance-free life. Some of the ways in which we keep up with Optum’s standards include:
- Cutting-edge Medication-Assisted Treatment (MAT) allows successful detox and seamless care transitions
- Clinical assessments for both substance use disorders and mental health disorders ensures holistic treatment and healing
- Emphasis on engaging, accessible aftercare keeps clients connected after completing their treatment program
- Providers with targeted specialties provide high-level experiences with each of our therapeutic modalities
- Dedicated case managers work with each client to plan for discharge, aftercare and care transitions
- Intentional staff training ensures every provider and team member is working collaboratively on client care
- One-on-one attentiveness to client progress, including regular evaluations and knowledge-based assessments
We care about you or your loved one beyond the walls of our center. Our programs are designed not just to help you heal, but to help you succeed. We work closely with our clients to make a plan for their long-term care and to make sure they feel comfortable following it. Our aftercare strategies ensure you continue to feel connected, supported and encouraged by your recovery community as you move through life and find fulfillment in sobriety.
For more information about Optum Platinum Status, our other insurance information, admissions and more, please reach out to our team. Call us today at 888.986.7848.