56號提案基於價值的支付專案
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.
在確定這些措施時，DHCS 考慮了幾個因素，包括： 利害關係人和倡議者的意見，措施是否與部門其他品質工作一致；受影響的受益人數量；以及該措施是否可以透過行政方式實施等。
為了解決和考慮健康差異，DHCS 將為與被診斷患有藥物濫用障礙或嚴重精神疾病或無家可歸的受益者相關的活動支付更高的獎勵金額。
請參閱以下此程式支援文件的連結。 該計劃獲 CMS 和加利福尼亞州立法機關授權，從 7 月 1, 2019, 到 6 月 30, 2022 之間，運行。 該計劃涵蓋以下評級期間：七月 1、2019、至十二月 31、2020、2021 年曆年（CY）（一月 1、2021 至十二月 31、2021）和 2022 年度（一月 1、2022 至 2022 年 12 月）。
提案 56 — VBP 定向付款計劃於 30 2022 年 6 月結束，是唯一結束的 56 號定向付款計劃。 注意：只有專門與提案 56 — VBP 關聯的服務將不再適用於 30 2022 之後的服務日期獲得定向付款的資格。
有關此專案的任何管理式醫療問題，請透過DHCS Prop56DP@dhcs.ca.gov 聯絡 Prop56DP 團隊。