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New York State Medicaid is reforming healthcare payments to value-based models, focusing on behavioral health. They addressed gaps in quality measures through collaborations and expert panels, creating a model for other states.

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Area of Science:

  • Health Policy
  • Healthcare Reform
  • Behavioral Health Services

Background:

  • New York State Medicaid is transitioning from fee-for-service to value-based reimbursement.
  • Behavioral health services are central to these reforms.
  • Existing quality measures for behavioral health lack breadth and relevance.

Purpose of the Study:

  • To describe how New York State addressed gaps in behavioral health quality measures.
  • To present a model for value-based reform initiatives.

Main Methods:

  • Utilized inter- and intra-agency collaborations.
  • Convened a panel of academics, providers, and consumers.
  • Developed a behavioral health quality measurement agenda based on panel recommendations.

Main Results:

  • Identified and addressed critical gaps in behavioral health quality measurement.
  • Established ongoing partnerships to support reform initiatives.

Conclusions:

  • Inter- and intra-agency collaborations are effective in developing relevant quality measures.
  • The New York State model can guide other states in value-based behavioral health reform.