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CalMHSA played a critical role in supporting counties’ implementation of California Advancing and Improving Medi-Cal (CalAIM) within behavioral health, working with the Department of Health Care Services to facilitate the documentation, policy, and payment reforms necessary for CalAIM initiatives. We provided expertise to counties on payment reform modeling, CPT coding, communications, BHQIP monthly to-do lists, and webinars on payment reform and CalAIM transformation. Details, links and resources for some of these important components are below.

Contents

Payment Reform Impact Modeling

CalAIM Drug Medi-Cal ODS Outpatient Services Fiscal Impact Model 

CalAIM Drug Medi-Cal State Plan Outpatient Services Fiscal Impact

CalAIM Specialty Mental Health Outpatient Services Fiscal Impact Model

Payment Reform Webinar Recordings
Webinar Details Downloads
IGT 101 – Introduction to Intergovernmental Transfers Recording | Slides
IGT 102 – Optimization of IGTs Based on Local Funding Sources Recording | Slides
Best Practices for System Shifts Related to Payment Reform 101 Recording | Slides
CBHDA CalMHSA DHCS Payment Reform Webinar Recording | Slides

 

Best Practices White Paper

CalMHSA works with the Department of Health Care Services (DHCS) to help counties achieve the behavioral health payment reforms necessary to implement California Advancing and Innovating Medi-Cal (CalAIM) initiatives. This includes collecting fiscal data from all counties to use in the development of new rates tied to Current Procedural Terminology (CPT) codes, as well as hosting payment reform webinars for county leadership and their staff.

CalMHSA analyzed cost surveys from all 58 counties and their contracted providers to help DHCS develop and evaluate new payment rates. To aid counties in the completion of these cost surveys, CalMHSA created survey instructions and training materials and hosted weekly office hours. In addition to rate review, CalMHSA helped counties create coding crosswalks, document and material review, and code analysis to support the CPT billing codes.

Additional payment reform resources:

Rate Setting: Supplemental Materials (password protected)