About this Toolkit
This toolkit was created to provide key information about payment reform for the behavioral health community in Arizona. The goal is to ensure that the unfolding value-based purchasing models help achieve improved care, improved health and better costs.
Things have been moving quickly in the Arizona Behavioral Health environment as this toolkit was developed. A new governor, the merging of the state Division of Behavioral Health Services (DBHS) and the Arizona Health Care Cost Containment System (AHCCCS -- the state Medicaid agency), and a rapid ramp up of a new integrated care Regional Behavioral Health Authority (RBHA) structure have all been part of the changing landscape, including value-based purchasing components for all Medicaid services.
To help make sense of the changing payment landscape, Dale Jarvis and Associates, LLC was retained by the Arizona Council Of Human Service Providers to work with a broad range of behavioral health stakeholders to develop a Behavioral Health Payment Reform Toolkit to support payment reform inside Arizona’s RBHAs.
The Behavioral Health Payment Reform Toolkit contains a set of materials that can be adapted to different populations served by the RBHAs, including adults with serious behavioral health disorders, youth with serious emotional disturbances, youth in the child welfare system, and other Medicaid enrollees with mental health and substance use disorders.
The toolkit represents a set of agreed upon payment models, performance measures, and implementation approaches that are relevant to Arizona’s RBHAs and delivery system. RBHAs and providers can use this material to guide their triple aim efforts. The intention is for each RBHA to adapt ideas from the toolkit to their particular environment, using the guidance provided by the toolkit to accelerate their transformation efforts.
Things have been moving quickly in the Arizona Behavioral Health environment as this toolkit was developed. A new governor, the merging of the state Division of Behavioral Health Services (DBHS) and the Arizona Health Care Cost Containment System (AHCCCS -- the state Medicaid agency), and a rapid ramp up of a new integrated care Regional Behavioral Health Authority (RBHA) structure have all been part of the changing landscape, including value-based purchasing components for all Medicaid services.
To help make sense of the changing payment landscape, Dale Jarvis and Associates, LLC was retained by the Arizona Council Of Human Service Providers to work with a broad range of behavioral health stakeholders to develop a Behavioral Health Payment Reform Toolkit to support payment reform inside Arizona’s RBHAs.
The Behavioral Health Payment Reform Toolkit contains a set of materials that can be adapted to different populations served by the RBHAs, including adults with serious behavioral health disorders, youth with serious emotional disturbances, youth in the child welfare system, and other Medicaid enrollees with mental health and substance use disorders.
The toolkit represents a set of agreed upon payment models, performance measures, and implementation approaches that are relevant to Arizona’s RBHAs and delivery system. RBHAs and providers can use this material to guide their triple aim efforts. The intention is for each RBHA to adapt ideas from the toolkit to their particular environment, using the guidance provided by the toolkit to accelerate their transformation efforts.
The Consulting Team
Dale Jarvis and Associates is a consulting firm in Seattle, Washington specializing in development and implementation of health and human services payment models and service delivery designs to support the American healthcare system’s transition from a model that pays for volume to one that pays for value. Dale Jarvis, CPA, the firm’s founder, has spent the last twenty-five years working with governments, health plans and providers to align the mental health and substance use disorder systems with healthcare reform. He has written extensively on this work and is the co-author of two books on healthcare system redesign. Since the Affordable Care Act became law in 2010, Dale has worked on health reform projects in 21 states.
Karen W. Linkins, Ph.D. is Co-Founder and Principal of Desert Vista Consulting, where she specializes in systems transformation in the health, behavioral health, and human services fields through strategic planning, organizational development, evaluation and quality improvement.
Jennifer J. Brya, MA, MPP, is Co-Founder and Principal of Desert Vista Consulting where she applies over a decade of experience evaluating and studying innovative, collaborative treatment models and programs to build capacity within health, mental health and substance use treatment systems to meet the needs of high-cost, complex populations.
John Freeman has more than 13 years of experience in improving organizational operations and providing research, analysis and management for a range of interdisciplinary projects. Since 2007, John has been working on projects at the intersection of health care reform and behavioral health, with more recent work including other human services, such as housing.
Karen W. Linkins, Ph.D. is Co-Founder and Principal of Desert Vista Consulting, where she specializes in systems transformation in the health, behavioral health, and human services fields through strategic planning, organizational development, evaluation and quality improvement.
Jennifer J. Brya, MA, MPP, is Co-Founder and Principal of Desert Vista Consulting where she applies over a decade of experience evaluating and studying innovative, collaborative treatment models and programs to build capacity within health, mental health and substance use treatment systems to meet the needs of high-cost, complex populations.
John Freeman has more than 13 years of experience in improving organizational operations and providing research, analysis and management for a range of interdisciplinary projects. Since 2007, John has been working on projects at the intersection of health care reform and behavioral health, with more recent work including other human services, such as housing.
Project History
The genesis of the toolkit has included the following activities:
- Sponsors Committee and Steering Committee: We assembled a Sponsors Committee made up of the funders for the project and a Steering Committee made up of a broader cross-section of stakeholders to finalize the project work plan and timeline, identify resources, and oversee the project.
- Project Team Development: We identified individuals to participate in a Project Team to help design the Toolkit. This team was comprised of a cross-section of payors/purchasers, providers, and consumers/family members that represent different regions and sub-populations (e.g., age, ethnicity, severity). Project Team members participated in a set of full group meetings, webinars, and subgroup work sessions to complete the various parts of the Toolkit.
- Research: The consulting team compiled research materials to support the work of each workgroup.
- Boot Camp: The Project Team kick-off will consisted of a 1.5 day boot camp providing a comprehensive overview of all of the components of payment reform and how they fit together.
- Assessment: The consulting team developed a Provider Readiness Self-Assessment that was completed by 47 provider organizations across Arizona. Additionally, the consulting team interviewed the leadership of each RBHA, as well as several providers.
- Design Activities: Design activities were completed to build each component of the toolkit, based on the results of the forgoing work, ensuring that the material was relevant to the Arizona RBHA environment.
- Toolkit Rollout: The consulting team conducted an in person and web-based presentation of the draft toolkit for stakeholders, providing opportunities for discussion and suggestions of additional material and other changes.
- Next Steps: The consulting team will meet again with the RBHA leadership and discuss the contents of the toolkit. Once the RBHAs establish their VBP polices, the toolkit will be revised to add more content to help providers get ready for succeeding under the RBHA policies.