Josh Barson, a representative of the Bear River Health Department, asked the Rich County Commission to sign a formal letter requesting that the agency enter a Medicaid capitation model for substance‑use treatment services.

Barson told commissioners that substance‑use treatment in the region is currently paid on a fee‑for‑service basis and that capitation would provide a lump‑sum payment based on an anticipated number of Medicaid‑eligible clients. “Our hope is to enter [capitation] by 07/01/2026,” Barson said, explaining that capitation would give the health department a fixed amount to plan services and allow earlier access for people who need treatment while Medicaid eligibility is still being processed.

Why this matters: Barson said the capitation model is intended to increase resources and oversight for local substance‑use services, allow the health department to contract with and audit providers, and reduce gaps in care when clients are awaiting Medicaid enrollment.

Details from the presentation and discussion
- Current model: Medicaid reimbursement for substance‑use treatment is fee‑for‑service; the Bear River area is the last region in the state not capitated for those services.
- Capitation approach: a lump sum calculated from expected Medicaid eligibles for a service area; the provider (or consortium) manages care within that budget.
- Oversight: Barson said capitation would require providers to contract with the health department, giving county authorities more ability to audit and oversee services and reduce fraud risk.

Commission action and next steps
Commissioner discussion led to a motion to assign the capitation request. Commissioners clarified that the current January motion was to authorize sending a formal letter of request and to gather more details later: the county will receive another presentation before any decision to enter capitation is finalized. The commission noted the process could take about a year.

The commission voted to sign the letter of request; Barson and the health department will return with a full proposal and additional details for review before the county makes a binding decision to enter capitation.