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. 2021 Feb 1;72(2):180-185.
doi: 10.1176/appi.ps.202000129. Epub 2020 Dec 3.

Design of a Payment Decision-Support Tool for Coordinated Specialty Care for Early Psychosis

Yuhua Bao  1 , Yan Li  1 , Philip J Jeng  1 , Jennifer Scodes  1 , Michelle A Papp  1 , Jennifer L Humensky  1 , Melanie Wall  1 , Rufina Lee  1 , Jessica S Ancker  1 , Harold Alan Pincus  1 , Thomas E Smith  1 , Lisa B Dixon  1
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Design of a Payment Decision-Support Tool for Coordinated Specialty Care for Early Psychosis

Yuhua Bao et al. Psychiatr Serv. .

Abstract

A strengthened evidence base and earmarked federal funding have spurred the implementation of coordinated specialty care (CSC) for people experiencing early psychosis. However, existing funding mechanisms are insufficient and unsustainable to support population-wide deployment of CSC. This article describes the design framework of an innovative payment model for CSC that includes a bundled case rate payment and an optional outcome-based payment. To assist CSC payer and provider organizations in designing payment systems tailored to local preferences and circumstances, the research team is developing a decision-support tool that allows users to define design choices and provide input. The authors document the analytical algorithms underlying the tool and discuss how it could be further developed or expanded for CSC and other behavioral health interventions that feature an interdisciplinary team of clinicians and nonclinical professionals, public education and outreach, patient centeredness, and a recovery orientation.

Keywords: Coordinated specialty care (CSC); Early psychosis; Financing; Funding; Reimbursement.

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Conflict of interest statement

Disclosures

The authors report no financial relationships with commercial interests. Editor Emeritus Howard H. Goldman, M.D., Ph.D., served as decision editor on the manuscript.

Figures

Figure 1.
Figure 1.
Components and design choices of the CSC payment system
See this image and copyright information in PMC

References

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