#but i feel like i still have to address the whole. potential discrimination and triggering of a suicidal episode thing lol | Explore Tumblr posts and blogs

cupsofsuga · 5 years ago

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𝐅𝐈𝐍𝐄 𝐋𝐈𝐍𝐄 ━ 𝐘𝐀𝐍𝐃𝐄𝐑𝐄 𝐁𝐓𝐒 𝐇𝐄𝐀𝐃𝐂𝐀𝐍𝐎𝐍 *:·。.

{ ⚠️} WARNING - This is a yandere au, meaning the following may be triggering to some viewers. I am not trying to discriminate the boys in any way, this is for entertainment purposes. Viewer discretion is advised!!!

{ ☕️} NOTE - I changed up the plot just a teensy bit, love!! this is fanboy!bts with idol!reader

{ 💐} ANON ASKED - ❝ Hcs of yan idol!bts with an idol!s/o uwu ❞

━━━ 𝐊𝐈𝐌 𝐒𝐄𝐎𝐊𝐉𝐈𝐍

jin is an old, childhood friend of yours that departed from your life as your career skyrocketed

he’s a distant memory, but, to jin, you mean everything

how must he move on when your smile sits in the sun? how can you expect him to simply forget about you when he feels your touch in the wind and sees your eyes in the stars!?

this life is not for you, rather, the sweet, mundane one you and him planned for in blanket forts during the time of your youth

oh, what he’d do to lay his hands upon your summer skin and to look into the ornaments of your irises…

jin’s obsession only intensifies when he found your address and broke into your estate days later

he left old polaroids with dates stamped from nearly a decade ago on your dresser

even going as far as to sleep in your bed

inhaling your scent, relishing in the ghost of your form, the revelation brought him to tears

luckily, you didn’t take notice to your damp pillow that jin had broke down on

but, god, does he miss you…

after one of your concerts, you stumbled sluggishly to your dressing room

there was no answer as to why you were so lethargic, but, you only assumed it was the downfall from the adrenaline rush you received from the shrill screams from fans

without even bothering to change our of the skimpy outfits you were obligated to wear, you nestled yourself onto the leather couch

with a numb body, before you fell into a slumber, you hear a relatively sweet voice as they comfort and coo your name like the melody of a dove

❝ it’s ok, it’s ok. everything will be ok, you’re safe now, y/n/n… oh, how i have longed for this single moment for so, so long! we’ll be happy together, i promise you. we’ll be just fine… ❞

━━━ 𝐌𝐈𝐍 𝐘𝐎𝐎𝐍𝐆𝐈

min yoongi, a fan of y/n l/n!? that’s just absurd!

there’s no possible way that the cold-hearted, aloof, intimidating-as-all-can-be min yoongi could be some closeted fanboy… right?

but, just one peek into his rusted journal and you’ll uncover poetry that challenges oscar wilde and pages filled with doodles of your starlit face

one peak into his bedroom and you’ll find three cardboard cutouts with words of honey written on sticky notes that are strung upon your form

you’ll see posters littered all around the room, even a few taped on his ceiling so you’d be the first thing he sees when his alarm disrupts him of his slumber

one peak at his body and you’ll find tattoos littered upon his skin from everything to your name, to your favorite flowers, to your full-on face that he hides under chunky sweaters

there must be a million quotes of your songs that he deluded himself into believing was intended just for him inked upon his skin forever

all of those words he typed with the intention of escaping reality and joining you hand-by-hand into a new future are his source of light in these grey, gloomy days

and don’t get me started on all of those times he accidentally wrote your name during exams or how he spent his nights gazing into the cardboard cutout before him just praying that with some magic spell, you’d come alive and be there with him

yoongi is not just some devoted fan, no

he’s your soulmate

and this man is willing to walk straight into the depths of hell and crawl his way out just to prove it so.

━━━ 𝐉𝐔𝐍𝐆 𝐇𝐎𝐒𝐄𝐎𝐊

hoseok’s idea of a typical friday night would not be lying and rebelling against his parents just to join his friend and be packed like sardines in an abnormally-heated arena

the sweaty-scented mosh pit adorned with dozens of fans screaming for an idol he doesn’t even remember the name of, he’d just about rather be anywhere now

that is until you waltz out and the shouts intensify, everyone chanting your name as you show off your sugary-sweet smile like a king would with a crown

hoseok might as well have melted into the germ-infested floor before him from how stunned he was upon seeing you for the first time

and your voice!

god, the way you sang with such a level way of elegance sounded like the coo of a dove, the fits of laughter you shared had the poor sunshine in the crowd grow a weak-hearted smile

your eyes shined like wild stars as you looked upon the faces of every individual guest and beaming at the way they so cheerfully smiled for you

and you looked straight at hoseok! he swears you did!

as the glistening lights fade and you turn tail and walk off stage, you are completely oblivious to the boy in the crowd who’s left his heart on a silver platter just for your liking

he leaves the arena giddy, practically shaking with excitement in his seat and blabbering about every breath you took as his friend drives him back to his home

and this poor, but immensely infatuated boy doesn’t earn an inkling of shut-eye for the next 3 days due to him obsessively stalking all of your content

he’ll fake a cough and skip school just to lie in bed, listen to your music and fantasize about all of those lovestruck lyrics you sing being solely intended for him

hoseok will spend hours upon hours looking through photoshoots of yours

even spending as far as 4 hours staring at the same picture of you, tracing his fingers upon the pixelated screen and imagining it was your skin he caressing

you’re his whole life now!

hoseok doesn’t know what he’d do without you…

━━━ 𝐊𝐈𝐌 𝐍𝐀𝐌𝐉𝐎𝐎𝐍

oh, the proper and pristine kim namjoon

how much more perfect could you get with a wealthy lifestyle, having the privilege to attend some elite school and terrible, terrible parents?

how he’s just a mangled heart in the hands of a monster

but, as the all-mighty, alpha-male facade drops, we’ll witness the truth behind all that faux dominance

pray into the truth that’s itched under his skin and you’ll find a soft, gooey centerpiece that’s sweet and submissive

after some pointless bicker with his father, namjoon will return to his bedroom, door locked as relishes in his only source of joy: you

he’ll lie down in his expensive sheets, fantasizing about your sweet voice and touch, caressing him and cooing him of his worries

namjoon will cling onto a body pillow, staining the fabric with his tears

his tenacious grip (on what he fantasizes being you) will not weaken and will remain to be his only form of comfort in these grey days

and on the laptop before him, he’ll turn on one of your lives from the past, pretending, just for now, that you are here and you are real

all those other eyes that also watch you, they’re not real!

it’s just you and him

and having the privilege to lie down and relish in your disgustingly sweet essence is all-too infatuating for his poor heart to handle!

knowing that at the end of the day, he’ll always have you saved his life in more ways than one

knowing that he is yours and you are his, he has found tranquility.

━━━ 𝐏𝐀𝐑𝐊 𝐉𝐈𝐌𝐈𝐍

hours upon hours of scrolling with those all-too-familiar but infatuating jolts to his heart, jimin comes across a photo

a photo of you and a friend, just a little too close for his liking…

and there, we witness a tsunami of insecurities and doubts who have biased jimin for its affection

his mind reels back and forth between the potential truth and reassurance:

you love him! yes, you love him! you liked his comment once! and you even noticed him during a live stream 3 months, 1 week and 4 days ago!

and he’s not crazy, he just loves you so, so much! i mean…

yes, he did strangle a girl that caught your sweatshirt when you threw it into the crowd, but that was all in the past!

this is in the present, and jimin loves you more than you’ll ever know!

and oh, how dreamy and overwhelmingly immaculate that night was…

how he savored every breath that left your mouth as you sang for the arena, how the tears fell down his cheeks as the revelation of your presence knocked the air out of his lungs, and how even months after the concert, he still keeps the clothes he wore that night safely tucked in a rack cover

not a single second goes by where jimin does not think of the luminescence of that single night and just how golden your single presence was

but, for now, he is departed from your form and must find comfort by his lonesome

jimin will scroll through fanfiction, feeling his heart quicken with every word that makes up for his fantasies, satisfying him of his deprived need for you

he has lost count of how many imagines he’s saved at this point, but, then again, he doesn’t care

all that is valid is the pandemonium he sits in while relishing in the fantasy of you being with him, and to hold the privilege of simply waking up next to you in his embrace

as your songs and his hushed sobs echo, jimin grips onto the pillow and lets your cherubic voice soothe him of his sorrows

and for just this short time, jimin can let your seraphic voice bring him serenity.

━━━ 𝐊𝐈𝐌 𝐓𝐀𝐄𝐇𝐘𝐔𝐍𝐆

yeah……… you’re fucked

after enduring the torture of public school and numerously writing down your name when he intended to write down some algebraic expression he couldn’t remember if he tried, taehyung has returned home

and nothing feels better than satisfying that eternal longing held within him

he’ll ignore his parents and their attempt at small-talk, mumbling something about needing to finish homework and locking himself in his room

and what we see in his room is………. terrifying…? infatuating…?

i mean, your face is EVERYWHERE

posters, polaroids, selfies, all splattered across the walls, ceilings, and even his locker at school

there’s even a single screenshot taped above his desk of the smile plastered on his face when you read his comment: “i love you” during one of your live streams

taehyung then open his sketchbook, smiling fondly with his heart battering in his chest as he flips through past sketches of your beaming face with flowers and fruits adorning the pages

he seeks an empty page, beginning another one of his trillion sketches of you, his muse

this boy doesn’t need a picture to follow from, he knows every one of your facial features from heart

from the shape of your nose to the single mole on your cheek, taehyung has got it imprinted in his mind

and as your song spills from his phone while he’s sketching your wondrous eyes, he thinks back to the sacred memory of when he attended your concert

hearing you serenade thousands upon thousands of fans, including him, wasn’t anywhere near the most momentous part of that night

claiming he was your boyfriend to the guards, shining his sugary-sweet boxy smile and having access to follow you backstage was the best moment of his entire life spent on this planet!

he snapped some photos of you as you scrolled through social media on the leather couch, relishing in the way you so simply… lived

yeah, the guards nearly killed him for that one, but, having the privilege to admire you in your natural state made everything worth it

after all, if it was for you, anything was worth it.

━━━ 𝐉𝐄𝐎𝐍 𝐉𝐔𝐍𝐆𝐊𝐎𝐎𝐊

as jungkook lays sprawled out on dirty sheets, the voice of y/n l/n echoes and reverberates in his eardrums

this is what tranquility is; this is what peace means, even it’s only temporary

and god, there must be something laced with your voice because never in his life has jungkook felt something like this

floating through space, running on stars, dancing on saturn’s rings; this is the feeling that blossoms within jungkook’s chest

and for once, he can forget all the anger that lingers in the path of his past

trust me, these memories are not anywhere near pretty

from beating a boy to a bloody pulp for calling you a “dumb pop-star” to punching holes into the drywall after a drama channel gossips about a supposed new lover of yours,

jungkook is a complete psycho fan

and spending his rent on tickets for a fan-meet just proves how worthy you are to this stranger

words couldn’t do the emotion jungkook felt when he caught sight of you any justice

he might as well as stepped onto another planet because, god, he’s never seen a sight so astonishing

he finds stars in your eyes and finds himself lost in your smile which resembles a string of pearls

you are in every means perfect

and as his turns reaches near, you grasp hold of his hand to calm him of his nerves

alas, jungkook has found nirvana

he must have looked like such an idiot being so giddy and excited for the human who has never seen him in their entire life

but finally, he has the privilege to meet face-to-face with the love of his life, and you bet he savors every single second of the time spent with you

jungkook even went as far as to have the signature you signed on his forearm tattooed, so your touch would be imprinted on his skin forever

now, you’ll be intwined for eternity…

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hypermoyashi · 6 years ago

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Okay, so, hi everyone? I’ve gotten some new followers, which is a bit surprising, and I’m sure some of you are aware of the discourse currently happening the mdzs fandom. Normally, as my about page states, I will not participate in fandom discourse under any circumstances, but as I was personally signaled out in this, I’ll be making an exception just this once. I’ll be placing everything under a cut just so those of you who don’t want this discourse showing up on your dash can avoid it.

Okay, so if you’re unaware, a blocklist was recently created of people in the fandom that minors should avoid/be aware of. I, as well as one of my good fandom friends, was on this list. I will not be posting links to said list in any way, shape, or form, as I believe it is poorly worded and just wholely not handled well in its original context.

I’d like to preface this entire post with one important idea: you curate your own fandom experience. I actually encourage blocking/blacklisting things and people who make you uncomfortable, just be respectful about it. You don’t need to announce it, or let someone know you’re blocking them. If I in any way make you uncomfortable for any reason, and you are uncomfortable talking to me about it to try and fix the problem, then please unfollow me, block me, or whatever will make you the most happy and comfortable. In the end, fandom is about fun, and it shouldn’t be taken too seriously. It shouldn’t be used to hurt people.

I can’t say I’m not upset that I and my friend were included, and while I don’t know most of the people on that list enough to make a judgment, based on the reasons my friend and I were listed, I don’t believe the judgment of the original creator of the list was wholly sound. For full transparency, I am going to include why I, personally, was signaled out.

The first reason is for my submission here: https://mxtxpositivity.tumblr.com/post/183334608470/fic-rec-realize-what-you-never-knew-by

The fic I recommended is a fic that the friend I previously mentioned wrote, and I recommended it because I enjoy it and I enjoy supporting my friend’s writing. Now, the fic in question is about the junior trio, but it is written in a context where they are older and not minors. To be fair, my friend did not tag for this, and the lack of a tag for it was not something that I, as her beta, caught, either. I don’t particularly intend to debate whether or not it’s okay to write sexual content about young characters after they’ve been aged up, as it’s a rather gray area and whether it will bother you will vary. If it does bother you, however, that’s perfectly valid and I encourage you to avoid it. Blacklisting is a wonderful thing, and ao3 now includes a function to exclude ships.

The second reason I was signaled out in this post is for this: http://hypermoyashi.tumblr.com/tagged/yaoi

And just so it’s clear that I have not altered or cleared this in any way, here’s a screenshot with the time and date in the corner:

I would scroll down to show you guys more of the tag, but there is none. My yaoi tag is just two posts. This is the basis for which I was said to “support yaoi.” I’d like to point out that one post is literally a criticism of the genre as a whole. I have no idea why I tagged the second post as yaoi, but it was reblogged three years ago. It is not something I would reblog and tag that way today. I’ve used the same blog, the same username, for well over seven years now. There is bound to be some stuff here that doesn’t reflect who I am today, and there is also bound to be things that I’ve mistagged or not tagged appropriately in the past. I do not have the energy to clean absolutely everything out, but if you would like to point something out to me, I will be happy to change it. For my purposes, I’m not going to be altering my yaoi tag, in case anyone wants to check it for themselves.

Now, just as an off-topic, I’d like to point out that I’m bi/gray ace. I don’t hate yaoi per say, but I do dislike the picture its common tropes paint of the lgbtqa+ community, as anyone who has spoken with me for five minutes about it can tell you.

This is all I was flagged for, but in the name of transparency, I am also going to include something that, had our original poster of the list seen, would’ve been additional reasons for me to land on the list.

I am writing an A.B.O. fic for HOB. It will also contain an explicit scene in the future, and it contains some pretty heavy triggers such as attempted suicide and CSA/abuse. I know A.B.O. tends to be controversial for many, many reasons, but for the record, all characters retain their full facilities during any and all explicit scenes, on or off screen, and are able to consent or not consent to what is going on. Anything of that nature that happens to a minor does not happen on screen and is appropriately tagged as CSA. I also do not endorse or want minors reading this fic, but I’ll get into that later.

Now, does any of this disprove that I’m a potential danger to minors? No, it does not.

For one, disproving a negative is an impossibility. To demonstrate this, I’ll be using the same analogy my statistics teacher used. You have a field. You’re looking for cows. To find some cows, you divide the field up into twenty sections. Unfortunately, you only have the capability to check five of the sections. You check these five sections, and you don’t find any cows. Can you say, for sure, that there are no cows in the field? Nope. Because it’s impossible to check every section, and there could be cows in the sections you don’t check.

I cannot open up the entirety of my memory and history to prove that I have definitely never hurt a minor. It is absolutely never my intention, and if I have, I deeply apologize for it. But I have no way of disproving a negative because it is mathematically impossible.

Now that we’ve gotten up to this point, some of you might be thinking, isn’t treating such a baseless accusation so seriously, in a way, giving it validity? Well, in a way, sort of. The accusation is entirely baseless, yes, and this is going to be the only time I’m going to argue something like this in this way. It upset me, and it’s there, so I want to address it.

Now, I’m going to reference my about page. Here it is:

The text reads, “Hello! I thought, after about five years of owning this blog, give or take, it was probably time to make an about page.

“I mainly write fanfiction, which is almost always posted to ao3 and linked here unless it’s particularly short. Minors are definitely welcome; I don’t reblog or post N**SFW images or videos, nor do I write smut, though please be aware that this blog is “view at your own risk.” I tag for common triggers and potentially harmful content, so it’s up to you to know your limits and blacklist appropriately. That being said, if you need me to tag anything in addition to what I already do, please don’t hesitate to ask!

“My fandoms right now are mainly Bungou Stray Dogs, Heaven Official’s Blessing, Mo Dao Zu Shi, Hakata Tonkotsu Ramens, Pandora Hearts, Vanitas no Carte, Akatsuki no Yona, and D.Gray-man. Please be aware that although I do have particular ships I like, I’m not really that into shipping as a whole.

“I don’t reblog shipping discourse nor will I interact with hostile shippers. If you would like to talk about shipping with me, please do, just be nice! As a bonus, I love platonic relationships, so please talk with me about those if you enjoy them, too.

“ところで、私の日本語はちょっとわるいですけど、話すのが好きです。

“Finally, I consider this blog to be a safe place for me and others that does not discriminate based on race, gender identity, sexual orientation, mental health, physical ability, national origin, or religion. If that bothers you, please click the “back” or “x” button on your browser.

“With all that out of the way, welcome to my blog! I love talking with people, so feel free to message me or leave an ask. I swear you won’t be bothering me. Happy blogging!”

Now, I am going to edit this at some point, because I have written smut now. It’s not posted, but it’s still something I intend to post. But yeah, as of 3/13 around 5pm, that was my about page, and I have not changed it for quite a while. (Sorry I’m not quite as chipper today ^^”)

One of the links on my about page leads to this page:

Which reads:

A quick guide to my tagging system!

my fanfiction: stuff I’ve written

text post: stuff I’ve made/said

q: things posted from my queue (it is a very long queue)

art by op: If there’s no source, then I’m reasonably certain that this art was created by the original poster. If I’m wrong, please let me know and I’ll delete it imeidiately.

icons: whenever I save an icon, whether I use it or not, I reblog it under this tag

personal and/or ramblings: just me talking. Sometimes I won’t even tag these kinds of posts

— mention: normally reserved for common triggers, i.e. “Donald Trump mention” or “sex mention”

n**sfw warning: as stated in my about page, I don’t reblog n**sfw images or videos, but I do reblog n**sfw fic recs (ie links to explicit content) that is unsuitable for minors. If you’re a minor viewing my blog, please blacklist this tag if you feel the need to!

spoilers: anything and everything I think constitutes a spoiler. Sometimes I’m bad about tagging these, though. I don’t tag for specific fandoms, like “su spoilers” or “bsd spoilers,” so please beware of that.

And, for reference, this is the basis for which I generally rate my fics:

G (General Audiences): Anyone can read this

T (Teen Audiences): Anyone 13+ can read this

M (Mature Audiences): Anyone 17/18+ can read this (16 is fine, too, I think, depending on what the reader is comfortable with. My M rated fics often include dark/sexual themes, though, so 17/18 is the more comfortable range)

E (Explicit): Only people who are 18+ should read this (probably not gonna rate anything this since I don’t write smut unless I just really don’t want to endorse any minors reading it)

Again, this should probably be updated as I have written smut, however infrequent. I try to tag for common triggers, and I have asked here that minors under a certain age not read particular fics. All of my fics that depict unhealthy relationships, darker or sexual themes, or anything that I would be uncomfortable with a minor reading are rated Mature or Explicit, depending.

So all in all, I have tried my best to provide a positive experience to anyone who enjoys my content, and I try to tag so that potentially harmful content doesn’t reach those that it might hurt. I’m not perfect, and I can’t control everything. A minor can still go in and read my Explicit/Mature fics on ao3, no matter how much or how loudly I ask them not to. My content is meant to inspire, to show that life can suck, but in the end, everyone is worth it and continue on.

And, on that caveat, I’d like to point out that I generally take a stance of “create and let create.” Freedom of expression is the greatest gift anyone can be given. Yes, avoid content that hurts you, but please don’t lash out at those who create it. Until you know exactly why they’ve created it, what their history is, and what thoughts or feelings they were working through while creating it, please leave them be. Creators should tag their works so people can avoid content that might be harmful to them, but content that is harmful to one person might be another person’s lifeline.

But the reason I’ve laid this all out is that I want you to judge for yourself. Do I seem like someone you want to be friends with? Do I seem like someone harmful? Do I seem like someone you are indifferent to? Please make the decision that is best for you, and if you happen to want to be friends, please let me know ^^

Now, finally, I hope to see a more positive fandom experience come of this. I say all this, however negative or bleak it might be for me, because it was important for me to work through my thoughts, and I hope that something positive can come of honesty and communication.

Please don’t go after the original poster of the list, if you know who they are. It’s better just to let it go. The person seemed to have had good intentions, however ill-executed they were, and talking to them is only going to create more ill will and negativity for everyone. I believe, at least in part, the reason their list is so unfounded and baseless is because the content they cited genuinely hurts them, and when creating the list, they did not look at the full context of everything they were citing. And, well, context is everything, really. This doesn’t really excuse them, as they still hurt people with a largely unhelpful and thoughtless post, but brewing the negative feelings helps no one. I would also like to state that the fact that the content hurts them is not the fault of any of the creators. If you tag appropriately, but someone doesn’t take the time to blacklist or otherwise protect themself from content they know will hurt them, then that’s on them.

Fandom is a really interesting place. It’s full of so many diverse and wonderful people--minors and adults, lgbtqa+ and allies, tons of different nationalities--we should really take more steps to look out for one another. If there’s anything I could be doing better, please let me know. My experience with the mdzs fandom hasn’t been great up to this point, and I want to change that. I love this show, and I also want to love the people who love it alongside me.

Remember, for every not so great person, there are twenty more lovely people just waiting to meet you. And I hope that, from here on, those lovely people get every good thing they deserve.

#discourse #csa mention #abuse mention #rape mention #suicide mention #really if you have any super common triggers please don't read this #not tagging the fandom #and it probably wont show up in the tags because looong #but yeah here is my only participation in discourse #id prefer no reblogs #but feel free to reply #or message me

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detox0000 · 4 years ago

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How Value-Based Care Can Improve Mental Health & Addiction Treatment

“I want to give up heroin, but I still want to have a beer on the weekend with my friends.” The simple desire was from Ben, a patient, referred to as community members, at Eleanor Health in Mooresville, NC. He had tried giving up heroin on his own, and continually relapsed, but no other treatment provider would accept him into their program. Other programs require full abstinence with the belief that if he wasn’t willing to give up every substance, he “wasn’t ready” and wouldn’t be successful in treatment. What resulted was a lack of trust in the healthcare system, and a spiral that made Ben feel like a failure. He lost his job and his partner, moved back home, and cycled in and out of hospital emergency rooms and 28-day rehabs.

Ben’s story is one we hear frequently. He was given opioids for an injury in high school, and ultimately became addicted. He had untreated anxiety, and the impact the injury had on his life — taking away his identity as a 3-sport athlete — led him to substances to cope and self-manage. His story with treatment is also one we hear frequently. The treatment landscape in this country and in his community, based on stigma, abstinence, and weak evidence, failed him.

Other segments of healthcare have embraced population health and value-based care — an approach that focuses on improvements in health, addresses care longitudinally, and works with the whole person. Newer financial models pay for healthcare differently and support population health and achieved outcomes, a move from fee-for-service to value-based payments. In mental health and addiction, these payment and care delivery models are only just emerging, but they have the potential to dramatically improve the health and outcomes for patients like Ben.

For payers looking to implement effective payment models, and providers that want to focus on outcomes, below are four critical components:

1. Not firing patients

Traditional addiction treatment programs only offer “one-size-fits-all” or abstinence-only care approaches that prevent treatment for patients who aren’t completely abstinent from all substances. Historically, these types of programs have “fired” patients — kicked them out of the program for non-compliance with certain criteria including negative urine drug screens and unwavering abstinence — a practice rooted in stigma and the false belief that addiction is a choice and moral failing.

As a result, many patients’ treatment journey consists of various starts and stops through several recurrent episodes of expensive, out-of-network treatment or inpatient treatment programs that aren’t evidence-based. And even newer innovative models of care require adherence to all components of the program, like attending a group meeting in order to get life-saving medication, a practice that further marginalizes those struggling with addiction.

Value-based programs are personalized and recognize that addiction is a relapsing condition just like other chronic conditions.

2. Taking care of the whole person

Many providers are unequipped to address whole-person needs and instead focus narrowly on presence or absence of substance use despite the evidence that the majority of patients have other physical and mental health needs that occur alongside their substance use disorder. Roughly 80% of patients with SUD have other co-occurring psychiatric disorders, including trauma, depression, and anxiety. Additionally, the bidirectional relationship between physical and mental health drives higher rates of chronic physical health conditions among patients with SUD. Untreated physical health conditions can trigger SUD to relapse. Finally, social drivers of health such as housing and income instability and lack of meaningful connectedness and life purpose, substantially impact SUD outcomes.

Any program that is not addressing co-occurring mental health symptoms, physical health, and social drivers of health is not providing adequate treatment.

3. Reimbursing based on the quality, not quantity

Historically, payments for healthcare services are determined by the number of services provided. This fee-for-service reimbursement system has contributed to an overall increase in the amount of services and cost of care, without a commensurate improvement in the quality of services provided.

This is especially prevalent in the addiction treatment landscape, which relies on predetermined 28-day stay durations and compulsory urine drug screens despite evidence that neither alone improves health outcomes. Value-based care demands addiction treatment providers demonstrate measurable outcomes aligned with the quadruple aim:

Improved health of populations

Improved patient experience

Improved care team experience

Reduced total cost of care

Alternative payment models support the ability to improve quadruple aim outcomes by reimbursing for interventions that are critical, yet traditionally not reimbursable in fee-for-service arrangements, including proactive outreach and engagement to remove barriers to initiating care and maintaining retention; healthcare navigation to prevent disjointed care journeys and resultant attrition; and community-based interventions to address social drivers of health; and peer recovery support services to mitigate risk of illness relapse.

Payers who don’t reimburse, and providers who won’t be reimbursed, based on quality, not quantity, are not committed to improved outcomes.

4. Taking on the Financial Risk of Entire Populations

Value-based care requires a change from an individual patient mindset to a population-based mindset. Instead of being siloed and focused on one illness or one individual, value-based providers build systems and partnerships that enable more efficient and effective touchpoints across an entire patient population, thereby improving the care journey and health outcomes while reducing per capita cost of care. Benchmarked to the quadruple aim, value-based providers should be able to demonstrate process and target outcomes in several domains, including:

Access — Time from request to first appointment is associated with one-year remission rates. Value-based providers must offer on-demand access to addiction treatment.

Improved health outcomes — Improved health cannot be narrowed to abstinence and negative urine drug screens. Longitudinal harm reduction models have been shown to reduce overdose deaths and improve health over time, more so than disjointed, abstinence-based episodic care.

Superior experience — Individuals with addictive disorders routinely face marginalization, stigma, shame and discrimination. Value-based providers must be measuring and constantly improving both the staff experience and the patient experience.

Total cost of care — Being truly value-based requires a willingness to put revenue at risk if total cost of care doesn’t decrease and health outcomes don’t improve, ideally by population to prevent “cherry-picking” of patients.

Taking on financial risk is the true test of value — and belief in a program and its outcomes — but rarely seen in mental health and addiction treatment.

Fast forward nine months to what really matters — Ben. After relapsing two weeks into his recovery journey at Eleanor Health, Ben has been sober from heroin ever since. While he started his journey unwilling to take medication assisted treatment (MAT), he recognized the need to alter his plan after his relapse. He has repaired his relationship with his family, has a new job, and is moving in with his partner. He also drinks less on the weekend since he started engaging with a different social circle, one developed through the relationship connections made through his Community Recovery Partner. His bi-weekly trips to the Emergency Room have ended. Not every urine drug screen has been negative, and that’s ok — he recognizes that he has to work on his sobriety every day and that it isn’t something that can be “fixed” in 28 days.

Ben’s story is not unique. It is based on a model built on data and evidence, which means thousands came before him. The addiction treatment system is just beginning to recognize the need for value-based care and alternative payment models towards the goal of adequately managing SUD as the chronic medical condition it is. Many providers and payers are piloting bundled payments, but this alone does not represent value-based care. Assuming the financial risk for an individual episode of care is a positive first step, but is only the beginning. To be truly value-based, care providers must be held responsible for the health and satisfaction of populations, and alternative payment models must reimburse for quality and outcomes, not quantity.

Corbin Petro is the CEO & Co-Founder of Eleanor Health, the first addiction and mental health services provider designed to deliver long-term patient recovery outcomes and modeled on value-based care delivery and payments. Eleanor provides whole-person, comprehensive care for mental health and substance misuse in outpatient clinics, virtually, and in the community and patient’s homes.

from https://www.eleanorhealth.com/blog/value-based-care-addiction

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from Eleanor Health Durham https://eleanorhealthdurham.wordpress.com/2020/08/21/how-value-based-care-can-improve-mental-health-addiction-treatment/ via IFTTT

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#Detox

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rehab006 · 4 years ago

Link

via Rehab,

For payers looking to implement effective payment models, and providers that want to focus on outcomes, below are four critical components:

1. Not firing patients

Value-based programs are personalized and recognize that addiction is a relapsing condition just like other chronic conditions.

2. Taking care of the whole person

Any program that is not addressing co-occurring mental health symptoms, physical health, and social drivers of health is not providing adequate treatment.

3. Reimbursing based on the quality, not quantity

Improved health of populations

Improved patient experience

Improved care team experience

Reduced total cost of care

Payers who don’t reimburse, and providers who won’t be reimbursed, based on quality, not quantity, are not committed to improved outcomes.

4. Taking on the Financial Risk of Entire Populations

Access — Time from request to first appointment is associated with one-year remission rates. Value-based providers must offer on-demand access to addiction treatment.

Taking on financial risk is the true test of value — and belief in a program and its outcomes — but rarely seen in mental health and addiction treatment.

from https://www.eleanorhealth.com/blog/value-based-care-addiction

from Eleanor Health Durham https://eleanorhealthdurham.blogspot.com/2020/08/how-value-based-care-can-improve-mental.html via IFTTT

from Eleanor Health Durham https://eleanorhealthdurham.wordpress.com/2020/08/21/how-value-based-care-can-improve-mental-health-addiction-treatment/ via IFTTT

from Rehab https://rehab06.blogspot.com/2020/08/how-value-based-care-can-improve-mental.html via IFTTT

#Rehab

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drugrehb9 · 4 years ago

Link

via Drug Rehab,

For payers looking to implement effective payment models, and providers that want to focus on outcomes, below are four critical components:

1. Not firing patients

Value-based programs are personalized and recognize that addiction is a relapsing condition just like other chronic conditions.

2. Taking care of the whole person

Any program that is not addressing co-occurring mental health symptoms, physical health, and social drivers of health is not providing adequate treatment.

3. Reimbursing based on the quality, not quantity

Improved health of populations

Improved patient experience

Improved care team experience

Reduced total cost of care

Payers who don’t reimburse, and providers who won’t be reimbursed, based on quality, not quantity, are not committed to improved outcomes.

4. Taking on the Financial Risk of Entire Populations

Access — Time from request to first appointment is associated with one-year remission rates. Value-based providers must offer on-demand access to addiction treatment.

Taking on financial risk is the true test of value — and belief in a program and its outcomes — but rarely seen in mental health and addiction treatment.

from https://www.eleanorhealth.com/blog/value-based-care-addiction

from Eleanor Health Durham https://eleanorhealthdurham.blogspot.com/2020/08/how-value-based-care-can-improve-mental.html via IFTTT

from Eleanor Health Durham https://eleanorhealthdurham.wordpress.com/2020/08/21/how-value-based-care-can-improve-mental-health-addiction-treatment/ via IFTTT

from Drug Rehab https://drugrehab8.blogspot.com/2020/08/how-value-based-care-can-improve-mental.html via IFTTT

#Drug Rehab

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