Integrating Behavioral with Physical Health Care to Improve Access to High Quality Care

Prepared For

U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation

Helping individuals with mental and substance use disorders obtain the health care they need to maintain health and well-being is a policy priority.

We are evaluating the Certified Community Behavioral Health Clinic (CCBHC) Demonstration, which aims to improve the availability, quality, and outcomes of community mental health center ambulatory care, in eight states. The demonstration includes a new payment system that accounts for the total cost of providing comprehensive services to individuals seeking care. It also integrates primary and behavioral health care services; facilitates more consistent use of evidence-based practices; and, through enhanced reporting requirements, helps assess the quality of care CCBHCs across the country provide.

The evaluation is examining the following:

  • How states developed and implemented their prospective payment systems
  • Successes and challenges in providing services under the new payment systems
  • Outcomes, costs, and quality of care for clients relative to comparison groups

This mixed-methods evaluation includes telephone interviews with state Medicaid and mental health officials at different stages of implementation, site visits to CCBHCs, analysis of cost reports and quality measures submitted by CCBHCs and states, and analysis of Medicaid claims and managed care encounter data obtained from states. The impact analysis uses a difference-in-differences model to estimate whether clients who receive care from CCBHCs experience improvements in costs and service utilization relative to within-state comparison groups of clients who receive care from other community mental health centers not participating in the demonstration. The findings will inform reports to Congress.

For additional information on the demonstration, visit 223 Demonstration Program for Certified Community Behavioral Health Clinics on the Substance Abuse and Mental Health Services Administration (SAMHSA) website.

Related Staff

Jonathan Brown

Jonathan Brown

Senior Director

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Crystal  Blyler

Crystal Blyler

Principal Researcher

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