Built upon clinical and operational excellence derived from evidence-based best practices, Beacon administers Autism Spectrum Disorder (ASD) services and benefits on behalf of health plans, employers and other purchasers of ASD services under a coordinated model of care.
Beacon’s management of Applied Behavior Analysis (ABA) treatment and outcomes incorporates screening and assessment, peer-to-peer care management, utilization, therapy and medication management. The goals of our autism program are to:
- Bridge the gap between each child’s chronological and developmental age as early and as rapidly as possible
- Maximize the child’s adjustment to mainstream settings
- Improve the child’s chances to live a full life
- Reduce overall health care costs
Quality-Driven Utilization and Care Management
Beacon offers a rational, quality-driven system for authorizing and monitoring the effectiveness of ABA therapy. First, the integrity of the autism diagnosis is established. Then, we apply utilization management support grounded in empirically established best practices including peer-to-peer collaboration, ongoing review of actual treatment gains and criteria-based provider profiling.
In addition to ABA services, our tiered care management approach for persons diagnosed with autism includes:
- Referrals to behavioral health therapists for comprehensive evaluation and assessment
- Intensive case management with our enhanced/comprehensive care management product
- Care coordination with families, caregivers, medical, community programs and education
- Psychotherapy and access to psychiatric services
- Parent training, social skills training and coaching support
- Consultation by a licensed peer reviewer
- Paraprofessional supervision
We monitor each child’s functional gains at appropriate intervals along with system-wide performance improvement initiatives. Success is measured by statistically-driven outcomes, using real-time clinical and encounter data collected on our proprietary Care Management platform. Quality benchmarks and outcome measures incorporate timely access to care, acceptability of services to members and their families and impact of clinical services measured by functional gains and quality of life improvement. These measures help purchasers determine clinical and cost effectiveness of services.