Ongoing meetings with HCA Behavioral Health, CalOptima, local private insurance plans and related organizations will help identify potential system-level metrics to drive quality improvement and explore potential rate structures, braiding strategies, provider requirements and incentives, as well as legal, fiscal and regulatory requirements that support BHST.
This component of the Behavioral Health System Transformation involves the development of performance- and value-based contracts. The goal is to move away from a system where payment is based on volume and costs to a system where payment is based on outcomes and value.
Contract templates that include value-based payments and identify performance metrics and incentives related to behavioral health services.
The goal is to make it easier to access and provide high-quality behavioral health care services that are culturally responsive and inclusive, regardless of the type of insurance a client carries.
Your participation in this process is vital, along with all stakeholders. Consumer, peer, and family member engagement are especially important.
Mind OC and HCA will make every effort to successfully engage the widest array of county and county-contracted staff, community partners and stakeholders. However, the support of community partners is necessary to ensure deeper engagement. Everyone must work together to ensure a diversity of participants.
Stipends and other supports such as meals and transportation will be available to support client, family and community engagement.
The exact structure for measurement and incentives will be determined as part of the stakeholder engagement process. Broadly speaking, metrics and incentives will be geared toward supporting improvement and achievement of benchmarks, with a transparent plan for reevaluation over time.
Metrics and associated incentives will address structural, process, outcome, client-reported and other elements, and will include health outcomes, health factors, clinical care, social determinants of health and care transitions, as well as client, family, and community experience.
Any measures valued by the stakeholders will be considered.
Once metrics and all other elements of the overall design are established, there will be an effort to align applicable compliance, funding, data sharing and other requirements and programs.
Be Well OC will look to other efforts across California and the nation.