Implementation Findings from the National Evaluation of the Certified Community Behavioral Health Clinic Demonstration

Implementation Findings from the National Evaluation of the Certified Community Behavioral Health Clinic Demonstration

Published: Sep 12, 2020
Publisher: Office of Behavioral Health, Disability, and Aging Policy, Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services
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Associated Project

Evaluation of the Certified Community Behavioral Health Clinic Demonstration

Time frame: 2016–2028

Prepared for:

U.S. Department of Health and Human Services

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

Authors

Allison Wishon Siegwarth

Rachel Miller

Courtney Kase

Joshua Breslau

Michael Dunbar

Key Findings
  • During the demonstration, states and CCBHCs have focused on increasing access to care, maintaining the staffing and scope of services requirements in the demonstration criteria, and ensuring coordinated care for CCBHC clients.
  • Nearly all CCBHCs added services and hired staff as a result of certification; in both demonstration years, nearly all CCBHCs employed the staff required or suggested in the criteria, and were able to add and sustain a range of evidence-based practices across demonstration years.
  • CCBHCs put into place various strategies to increase access to care, such as providing services outside of clinic locations and broadly using telehealth.
  • Staffing and adoption of new services were among the most common implementation challenges; state officials reported that these challenges were addressed in the second demonstration year.

Section 223 of the Protecting Access to Medicare Act, enacted in April 2014, authorized the Certified Community Behavioral Health Clinic (CCBHC) demonstration to allow states to test new strategies for delivering and reimbursing services provided by community behavioral health clinics. The CCBHC demonstration aims to improve the availability, quality, and outcomes of ambulatory services by establishing a standard definition and criteria for CCBHCs and developing a new payment system that accounts for the total cost of providing comprehensive services to all individuals who seek care. The demonstration also aims to provide coordinated care that addresses both behavioral and physical health conditions.

In September 2016, the HHS Office of the Assistant Secretary for Planning and Evaluation contracted with Mathematica and its subcontractor, the RAND Corporation, to conduct a comprehensive national evaluation of the demonstration. This report presents evaluation findings on the implementation of the demonstration as of April 2019. Findings draw on data collected from interviews with demonstration state Medicaid and behavioral health agency officials, clinic site visits, and progress reports submitted by all participating CCBHCs.

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