Value Based Payment Reform (VBP) Behavioral Health

Five Transformation Principles

For more information please visit: DSRIP – VBP


1. Person Centered Healthcare:

  • Individuals and their care givers or support team should be met with hopefulness
  • Assessments should be comprehensive and identify the person´s individual symptoms, risk and resources
  • Access to care should be available during expanded hours to accommodate the individual´s work, family and other commitments
  • All providers should be trained to identify service needs and appropriate level of care for mental health conditions. Level of Care for Alcohol and Drug Treatment Referral (LOCADTR) is required for determining level of care for substance use disorder (SUD)

2. Recovery Oriented:

  • System should include a broad range of services that support recovery from mental illness and/ or substance use disorders
  • System should support the acquisition of living, vocational and social skills
  • Treatment and planning must work with and for the individual person and their support system to develop and direct all aspects of the treatment and recovery experience

3. Integrated Service Providers:

  • Care coordination should be the foundation of care plans along with efforts to foster individual responsibility for health awareness
  • Providers should attend to both the physical and behavioral health needs of members
  • Community is critical. Access to the broad range of recovery and support services that support an individual to achieve self–identified: living, vocational and social goals
  • Peers, outreach and engagement services in the community, care management, home and community based services, housing support and more are all necessary to support someone as they work towards recovery

4. Data Driven:

  • Providers and Plans should use data to define outcomes, monitor performance and promote health and wellbeing
  • Providers should use service data to identify high risk/ high need members in need of focused care management
  • Metrics should reflect broad range of health and recovery indicators beyond those related to acute care

5. Evidence Based:

  • Working together the healthcare system should focus on treatment planning and delivery that supports medication induction, recovery supports, and plans for continued assessment and formal admission to the program
  • System should incentivize provider´s use of evidence based practices
  • System should provide or enable continuing education activities to promote interest and adoption of these evidence based practices
  • Medication Assisted Treatment (MAT): The medical professional should discuss MAT with service recipients and where appropriate prescribe amounts of medication that are consistent with the current stability of the client and supports for stabilization in the environment

Value Based Payment