How do Medicaid Value-Based Payment models impact Adults with Serious Mental Illness?

Cambridge Health Alliance’s Health Equity Research Lab (the Lab) has been awarded a 4-year grant to study Medicaid Value-Based Payment (VBP) models and its impact on healthcare equity for adults with serious mental illnesses (SMI) such as schizophrenia, bipolar disorders and severe depressive disorders.    

Individuals with SMI are one of the most expensive patient groups in the Medicaid program since Medicaid finances community-based long-term services that are necessary to an individual's care. VBP models aim to reduce expenditures and improve quality, transforming widely used fee-for-service payment models. Instead, VBP models hold providers accountable for the cost and the quality of services they deliver. There is evidence from some state programs that VBP models can achieve positive health and economic outcomes. However, there has been little evidence presented on how VBP models impact Medicaid beneficiaries with SMI and no evidence on how they impact health equity for racial/ethnic minority groups. 

Researchers, led by Lab director Benjamin Lê Cook and CHA psychiatrist/researcher Marcela Horvitz-Lennon, will analyze 2010-2019 Medicaid claims data from Oregon and New York and evaluate the impact of their VBP models on racial/ethnic disparities in physical and mental health treatment access, quality, effectiveness and costs. Results from this study will help other states decide how to reform their health systems, especially to address mental health disparities among Black and Latino Medicaid beneficiaries. 

To find out more about the study, please visit https://www.healthequityresearch.org/projects.