Optum Platinum Recognition Drug & Alcohol Rehab Facilities Near Me
What is Optum’s Platinum Recognition Program?
Optum’s platinum recognition program recognizes and rewards facilities and programs based on an evaluation of unbiased data compared to regional program benchmarks.1 Conditions evaluated include general mental health, substance use disorder (SUD), and eating disorders. American Addiction Centers’ Recovery First Treatment Center in Hollywood, Florida has been recognized as an Optum Platinum Recognition program.
Optum Platinum Recognition Goals
The goals of the program are to:1
- Identify and reward programs that deliver effective and efficient care.
- Share facility performance data quantified and compared against regional program benchmarks.
- Utilize data to measure variations in practice patterns, which drive increased costs and poor clinical outcomes.
Qualifying for Optum Platinum Recognition
To qualify for evaluation, programs must be in-network and meet the minimum volume requirement of 20 eligible admissions within the calendar year.1
Optum Platinum Recognition Metrics & Benchmarks
Qualified programs that meet at least 4 of the 5 metric benchmarks will receive Platinum designation. Effectiveness metrics include:1
- Readmission rates: Rate of unplanned readmissions to any level of behavioral health care within 30 or 90 days of discharge from that same level of care
- Follow-up measures are applied by diagnostic category: Rate of follow-up appointments kept within 7 or 30 days of discharge from an Inpatient or Intermediate Level of Care.
Efficiency metrics include:1
- Outlier Length of Stay (LOS): Measures admissions to a facility program and compares LOS to associated cohort benchmarks. The facility program is provided with a percentage of admissions that have a LOS that is higher than the associated benchmarks.
- Outlier Behavioral Health Episode Spend: Measures admissions to a facility program and compares episode costs to associated cohort benchmarks. The facility program is provided with a percentage of admissions that have an episode cost that is higher than the associated benchmarks.
- “Platinum Recognition for Facility-Based Programs.” Optum. https://public.providerexpress.com/content/ope-provexpr/us/en/clinical-resources/platRecog.html