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OCA outlines behavioral health spending measurement and options for a focused investment benchmark
Summary
OCA staff described a proposed method to measure behavioral health spending (claims and non‑claims) and presented options for a narrower investment benchmark that would prioritize outpatient and community‑based services, asking the advisory committee for input on measurement choices and timelines.
OCA presented its proposed approach to measuring behavioral health spending and canvassed options for a behavioral health investment benchmark to incentivize prevention, community‑based services and integration with primary care.
Staff described a two‑part measurement strategy: a numerator of behavioral health spending (claims and allocated non‑claims payments) and a denominator of total medical expenses. For claims‑based spending OCA proposes including lines where the primary diagnosis is a behavioral health diagnosis and additional service codes for screening/assessment; pharmacy spending would be included when the National Drug Code (NDC) corresponds to a behavioral health treatment.…
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