OCA proposes focused behavioral‑health investment benchmark emphasizing outpatient/community care; seeks stakeholder input

Monterey — The Office of Healthcare Affordability on Feb. 25 offered a proposed approach for a behavioral‑health investment benchmark that centers on strengthening outpatient and community‑based services and increasing timely, in‑network access to mental‑health and substance‑use disorder care.

Staff described two distinct but related tasks required by statute: first, measure total behavioral health spending across payers (the broad measurement task); second, set an investment benchmark intended to “sustain infrastructure and capacity” and shift resources toward lower‑intensity settings and improved access. OCA proposed separating the two: use a broad definition for measurement (claims and non‑claims spending across service settings) while using a narrower, policy‑oriented subset of spending for the investment benchmark.

Under the straw model presented to the Board and to the advisory committee, the benchmark would emphasize covered, in‑network outpatient and community‑based behavioral‑health services — for example outpatient facility visits, professional…