Community Care Publications

Community Care Publication Abstracts

2025 | 2024 | 2023 | 2022 | 2021 | 2020

Value based purchasing to increase tobacco cessation counseling and medications in behavioral health homes

Tobacco use among individuals with behavioral health conditions is higher than in the general population and a leading cause for morbidity and early mortality. This study examines a value-based payment (VBP) model to incentivize provision of tobacco cessation counseling (TCC) and pharmacological treatment with varenicline among 38 behavioral health homes (a person-centered approach to coordinating comprehensive healthcare in behavioral health service settings for individuals with chronic behavioral and physical health conditions) within a non-profit Medicaid behavioral health managed care network utilizing the Behavioral Health Home Plus (BHHP) model. Pre-post comparisons indicate that rates of filled varenicline prescriptions increased in the BHHP population from 10.01 per 1,000 service users to 19.01 per 1,000 service users following implementation of the VBP (p < .0001). Comparisons with other in-network behavioral health service users without BHHP or VBP indicate higher receipt of TCC (p < .0001) and varenicline (p < .0001) among the BHHP VBP group. This study provides some evidence that value-based purchasing may be used to incentivize provider agencies with behavioral health homes to increase access to tobacco cessation treatment for individuals with behavioral health conditions.

Effectiveness of value-based payment and Assertive Community Treatment to reduce psychiatric hospitalizations

To address high-cost inpatient utilization for those with severe and persistent mental illness, stakeholders from a County Department of Human Services, a Behavioral Health Managed Care Organization, and mental health providers created a value-based payment (VBP) model to shift funding from inpatient mental health treatment (IPMH) to intensive, evidence-based, community-based mental health treatment, Assertive Community Treatment (ACT). Using a retrospective observational study, individuals who received ACT from providers participating in the VBP (N = 2) were compared to individuals who received ACT from providers (N = 17) not supported through a VBP. Results show decreasing average ACT and IPMH expenditures as well as shorter lengths of stay over time for providers under a VBP compared to those not in a VBP. Access to care was not impacted. These results, including implications for behavioral health, are discussed in the context of quality of care.

Care management intervention for Medicaid-enrolled adults with first-time psychiatric admission

A behavioral health managed care organization in Pennsylvania expanded a bridging strategy associated with reducing multiple readmissions to Medicaid-enrolled adults with a first admission to an inpatient mental health service. The intervention consisted of active problem solving, screenings, assessment of individuals’ motivation for ongoing treatment, care management services, and resource coordination. The intervention was associated with significantly lower rates of readmission and higher rates of aftercare receipt within 30 days compared with nonreceipt of the intervention. Direct cost savings were achieved through fewer readmissions, but longer-term savings may be achieved by affecting the illness trajectory for individuals with behavioral health disorders.