The Alliance of Community Health Plans (ACHP) Behavioral Health Collaborative, Clinical Collaborative and Quality Leaders met concurrently on May 24 – 25 in San Diego, California. The Behavioral Health Collaborative provides behavioral health leaders at ACHP member plans a forum for rapid learning and an opportunity to play an integral role in informing ACHP programs. The meeting agenda addressed an array of topics including value-based payment, addressing the social determinants of health, recent policy issues, strategies to address opioid abuse, fraud, waste and abuse and the Make It Ok and Hilarious World of Depression initiatives. James Schuster, M.D., Community Care Behavioral Health (CCBH), UPMC Insurance Division and Lindsay Arrington, ACHP serve as leaders of the collaborative. Our thanks also to Judy Feld, M.D., formerly of Independent Health for her contributions to the collaborative over the years. With Dr. Feld’s departure, there is now an open leadership position with the behavioral health collaborative. ACHP will be reaching out to collaborative members about potential interest and for thoughts on strategies to keep the collaborative engaged.
In preparation for the meeting, we compiled a set of pre-reading materials, all of which relates to the topics on the agenda. These materials are designed to set the foundation for our discussions and will be referenced throughout the meeting to help provide perspective and guide insights.
There are two types of materials: “Recommended” and “Further” reading. We ask that you read the “Recommended” materials prior to the meeting. The articles designated as “Further Reading” are pieces we think are valuable, but if you have limited time, we would rather you concentrate that time on the recommended materials.
- The Shift to Value-Based Payment
- Succeeding in New Payment Models
- Addressing the Social Determinants of Health
- SAMHSA’s Homeless and Housing Resource Network
- Dr. Amit Shah will discuss how CareOregon is addressing the social determinants of health, focusing on three main areas: housing for the low-income population, food security and social supports/combating social isolation. Linked below are a number of background articles.
- A summary of CareOregon’s Housing with Services Program and some of the evaluation framework
- A case study of a member enrolled in CareOregon’s Housing with Services Program
- A Health Affairs article written about the impact of housing programs in Portland on health care expenditures and health outcomes
- The Business Plan document (CCC Housing) that describes CareOregon’s newest housing investment
- And several Food Rx documents that will give attendees
- Advocacy Update
Further Reading (optional):
- Guide to Alternative Payment Models
- HCP-LAN White Paper: Alternative Payment Model (APM) Framework
- General: Value-Based Payment
- The Effects of Pay-for-Performance Programs on Health, Health Use, and Processes of Care – discusses the effects of pay-for-performance programs targeted at the physician, group, managerial or institutional level on process-of-care and patient outcomes in ambulatory and inpatient settings.
- Should Medicare Value-Based Purchasing Take Social Risk into Account? and Social Risk Factors and Equity in Medicare Payment– examine the implications of a value-based health care delivery system on patients with social risk factors and on the providers who disproportionately provide care to socially at-risk populations; suggest strategies to account for social risk factors in Medicare payment
- Effects of Health Care Payment Models on Physician Practice in the United States – describes the effects that alternative health care payment models have on physicians and physician practices in the United States.
- RAND Payment Model Summary – summarizes the findings from the above study. Prepared by Thomas Foels, MD, executive vice president and chief medical officer at Independent Health.
- A Roundtable: The Hidden Issue – Fraud, Waste and Abuse