Behavioral Health Access to Care Metrics

This policy brief illustrates the use of case-mix adjustment models to create more equitable performance standards for health care performance measures. Client health outcomes reflect the combined impact of health plan performance, provider performance, client characteristics and other factors. Well-designed performance-based payment systems should not create incentives for managed care organizations to achieve a favorable risk pool or create disincentives for providers to engage high-risk clients who may be less able to adhere to standards of care. In addition, payment models should account for access-to-care challenges faced by rural and frontier regions of the state and avoid reinforcing regional resource disparities.