SAMHSA Managed Care - Massachusetts

Behavioral health Medicaid provider rates increased to pay for the cost of outcomes measurement

In May 2004, the MA Behavioral Health Partnership (MBHP), with the support of the State Medicaid Agency, launched a Statewide best practices and outcomes management initiative. The MBHP, a ValueOptions company, contracts with the State Medicaid agency to manage behavioral health benefits for over 300,000 Medicaid recipients enrolled in the MassHealth behavioral health managed care program. The primary goal of the outcomes initiative is to improve quality by identifying and promoting best practices among MBHP's network of 1200 providers. Providers will select from an MBHP-approved list of standardized outcomes instruments and measure outcomes for all levels of care. In response to provider concerns about the cost of measuring outcomes, MBHP increased provider rates by an average of 3.2% with support from MassHealth. Moreover, MBHP is assuming the cost of its "preferred" outcomes instrument--the Treatment Outcome Package (TOP). In return for the TOP subsidy, providers will share outcome data with MBHP. The data will be used evaluate the relationship of treatment outcomes to service costs, and to identify and promote best practice providers. For further information contact wayne.stelk@valueoptions.com. (E-mail communication with Dr. Wayne Stelk, VP Quality Management, MBHP, ValueOptions, 6/10/04)

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