第 56 号提案基于价值的支付计划
返回定向付款
概述
The Department of Health Care Services (DHCS) is releasing, as described below, the Value-Based Payment (VBP) Program measures. Additional details about the measure specifications will follow. The final measure set is subject to federal approvals. For Fiscal Year (FY) 19-20 the Governor’s Budget proposes a VBP through Medi-Cal managed care health plans (MCPs) that will provide incentive payments to providers for meeting specific measures aimed at improving care for certain high-cost or high-need populations. These risk-based incentive payments will be targeted at physicians that meet specific achievement on metrics targeting areas such as behavioral health integration; chronic disease management; prenatal/post-partum care; and early childhood prevention. At May Revision, a total of $544.2M ($250M Proposition 56 funds) in 2019-20 is proposed for this program, of which $140M ($70M in Proposition 56 funds) is specifically for Behavioral Health Integration. The program will be implemented for at least three years in the managed care delivery system, subject to funding approved in the final 2019 Budget. The implementation date will be July 1, 2019 for all measures including behavioral health integration measures; and January 1, 2020 for the Behavioral Health Integration Project Plan component.
在确定这些措施时，DHCS 考虑了几个因素，包括：利益相关者和倡导者的评论、该措施是否与其他部门质量工作相一致；受影响的受益人数量；以及该措施是否可以在行政上运行等等。
为了解决和考虑健康差异，DHCS 将为与被诊断为患有物质使用障碍或严重精神疾病或无家可归的受益人相关的活动支付更高的奖励金额。
请参阅下面该程序的支持文档链接。 该计划已获得 CMS 和加利福尼亚州立法机构的授权，实施时间为1年2019月 至30年2022月 。 该计划涵盖以下评级期：7 月1 、 2019至 12 月31 、 2020 ，2021 日历年 (CY)（1 月1 、 2021至 12 月31 、 2021 ）和 2022 日历年（1 月1 、 2022至 2022 年 12 月）。
第 56 号提案 - VBP 定向付款计划于30年2022月结束，并且是唯一结束的第 56 号提案定向付款计划。 注意：只有与第 56 号提案 - VBP 明确相关的服务在 6 月30 、 2022之后的服务日期将不再有资格获得定向付款。
如对该计划有任何管理式医疗问题，请联系 DHCS Prop56DP 团队，邮箱地址为Prop56DP@dhcs.ca.gov 。