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OCA frames focused behavioral‑health investment benchmark, tentatively targeting in‑network outpatient and community services
Summary
OCA outlined options for a focused investment benchmark to increase in‑network outpatient and community behavioral health spending among commercial and Medicare Advantage plans, using Rhode Island's 200% baseline example as a model while excluding pharmaceutical spend and planning phased expansion to Medi‑Cal.
The Office of Health Care Affordability resumed work on a behavioral health investment benchmark, proposing a focused approach that would target increased in‑network outpatient and community‑based behavioral health services paid by commercial carriers and Medicare Advantage plans.
Debbie Lindes, manager for the Healthcare Delivery System Group at OCA, described the distinction between comprehensive behavioral health spending measurement and a narrower investment benchmark that would be used to drive policy action. As an example, she summarized Rhode Island's benchmark set by the Office of the Health Insurance Commissioner: a requirement for carriers to raise community‑based…
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