The Behavioral Health HealthChoices system has been in place with the county right of first opportunity since the mid-90s.
The program has come under reconsideration for not having evolved, such that a carve-in program is being advanced.
Regardless of the program design (carve-in vs carve-out) one of the biggest trends nationwide is the move to VBP methodologies.
VBP is the combination of an alternative payment mechanism, coupled with performance-based/quality and outcomes incentives (in contrast to traditional fee-for-service methodologies).
Recently, OMHSAS created a VBP Steering Committee.
Behavioral Health Landscape
70% of individuals with coverage through Medicaid are in managed care plans
States’ Medicaid as the main payer serving the SMI population o An increase in behavioral health financing integration into health plans o Specialty health plans focused on the medical and behavioral health needs of the SMI population o Care coordination and integration initiatives
41 states with at least one behavioral health care coordination initiative: o Patient-centered medical home o Health home o Accountable care organization (ACO) o Dual demonstration o Certified community behavioral health clinic (CCBHCs) models
