Paying for Value in Behavioral Health

Value-Based Care, Transparency & Value

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Paying for Value in Behavioral Health

March 31, 2020

This report attempts to offer guidance to state Medicaid programs and other stakeholders on the lessons learned by states that have sought to develop innovative behavioral health VBP initiatives. Section III summarizes the recent experiences of three states whose Medicaid programs have experimented with different types of behavioral health VBP models: Vermont, New York, and Tennessee.

The descriptions and assessments of these models are based on interviews with key stakeholders in each state and a broad review of publicly available materials. Section IV synthesizes key lessons learned from these states, including their challenges, successes, failures, and adjustments. Finally, Section V includes a discussion of California-specific considerations. This includes an overview of the existing Medi-Cal behavioral health system, with a focus on managed care structures and existing payment methodologies for behavioral health services. The conclusion synthesizes key lessons for Medi-Cal based on the analysis of other states’ efforts