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OCA proposes focused behavioral‑health investment benchmark emphasizing outpatient and community services
Summary
Staff proposed a focused benchmark to encourage payer investment in in‑network outpatient and community behavioral health services, aligned with Prop. 1, SB 855 and SB 221; measurement of total behavioral health spending will remain broader.
OCA staff presented a straw‑model approach for a behavioral‑health investment benchmark that distinguishes two concepts: (1) measurement of total behavioral‑health spending as a component of total health care expenditures, and (2) a focused benchmark intended to drive investment toward specific services and care settings.
For measurement of total behavioral‑health spending, staff proposed to start with payer data for commercial and Medicare Advantage plans (claims and non‑claims payments) and eventually incorporate Medi‑Cal managed‑care organization data as that reporting is further developed. Staff emphasized that total spending measurement and the benchmark are separate: total spending uses a broad definition that can include…
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