The Department has developed a high-level model further defining the February 2016 program decision regarding the reimbursement of behavioral health services in ACC Phase II. The Department will retain a capitation payment to support the full continuum of behavioral health services from outpatient therapy to alternative community services to crisis response and hospitalization. One significant change from the current capitation will be limiting the use of the covered diagnosis requirements, where possible, in order to improve access to care.
In addition to the capitation, the Department will be reimbursing more behavioral health services delivered within primary care settings for low acuity and brief episodic conditions. To support integrated care, the Department will define a new set of services for behavioral health providers who work as members of primary care teams.