OCA to delay setting behavioral health investment benchmark to gather more payer data, board suggests revisiting in 2026

The Office of California (OCA) told its investment and payment work group that it will delay setting a statewide behavioral health investment benchmark and instead collect additional payer data and perform further analyses before proposing a formal benchmark.

OCA Assistant Deputy Director Margaret Abbrandt said the agency revised its approach after work group input and recent board and advisory committee discussion, explaining the new plan is to collect payer submissions for performance years 2024–2026 and use that analysis to inform any benchmark set in spring 2028 for performance year 2029. Abbrandt said the delay would allow staff to “identify and resolve challenges with the data submission process” before setting a multiyear target.

Why this matters: A formal benchmark would have directed payers to increase in‑network outpatient and community‑based behavioral health spending by a set percentage each year. Advocates and clinicians said a benchmark could accelerate access to outpatient care and integration with primary care; payers and some board members urged caution without more detailed data on payer variation, capitated payments and county specialty mental health spending.

What the data shows so far

OCA summarized analyses from three sources—Health Care Payments Database (HPD), Covered California and CalPERS—showing commercial payer behavioral health spending rising from about 5% to about 8% of total claims between 2021 and 2023, depending on the source. OCA…