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How does implementation of Pay-for-Performance and Collaborative Care impact utilization and health outcomes for Medicaid Behavioral Health patients

Award Number: F30MH127905
ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH
OPDIV: NIH
AWARD CLASS: DISCRETIONARY
AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS
PERIOD OF PERFORMANCE START DATE: 09/28/2022
PERIOD OF PERFORMANCE END DATE: 07/22/2024

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How does implementation of Pay-for-Performance and Collaborative Care impact utilization and health outcomes for Medicaid Behavioral Health patients - Project Summary/Abstract Medicaid patients experience significant health inequities. Medicaid patients have worse access to primary care, which leads to adverse health events and utilization of high-cost services. Medicaid behavioral health (BH) patients face even worse outcomes. Medicaid BH patients have higher rates of comorbid physical illness, and have four times higher spending and mortality rates than those without a BH diagnosis. Medicaid BH patients require complex clinical coordination, making care integration across delivery settings an urgent policy goal. In an effort to improve utilization and health outcomes for BH patients, Medicaid programs across the country are using pay-for-performance (P4P) to enact delivery system reform. P4P payment programs reimburse health providers for achieving quality process and outcome milestones instead of services volume. In 2014, New York (NY) Medicaid established a program by which health providers were paid using P4P in order to finance delivery reform initiatives. P4P may especially benefit BH patients, whose complex care needs coordination and increased quality standardization. There is a growing push for states to adopt Medicaid P4P, yet the impact of P4P programs have not been rigorously studied within Medicaid, especially in the context of behavioral health care. This study investigates if Medicaid P4P reform is effective at improving health outcomes and utilization for patients with unipolar depression, bipolar depression, and schizophrenia. We will use a difference-in-differences (DiD) analysis to compare utilization and outcomes of Medicaid BH patients receiving care from providers receiving P4P incentives to utilization and outcomes of Medicaid BH patients receiving care from providers without P4P incentives. In NY’s P4P program, about 70% of all Medicaid primary care providers participated in geographically diverse settings, enabling construction of exposed and unexposed Medicaid BH to payment reform. Descriptive statistics and preliminary results on outcomes will be presented. Analytic issues will be discussed, including approaches to address potential bias and group comparability such as propensity score weights. This proposal also includes a detailed description of my training plan, including scientific and career development training, as well as details on the excellent training environment of NYU Grossman School of Medicine’s MSTP program.


Issue Date FY	Funding FY	Legal Entity Name	Legal Entity Address	Legal Entity City	Legal Entity State	Legal Entity Zip Code	Legal Entity COUNTY	Legal Entity COUNTRY	Assistance Listing	Award Code	Budget Year	Action Date	Action Type	Action Amount

Issue Date FY: 2025 ( Subtotal = -$35,524 )
2025	2023	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Mental Health Research Grants	000	2	11/25/2024	NON-COMPETING CONTINUATION	-$4,524
2025	2023	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Mental Health Research Grants	001	2	5/27/2025	NON-COMPETING CONTINUATION	-$31,000
														Subtotal = -$35,524

Issue Date FY: 2023 ( Subtotal = $47,194 )
2023	2023	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Mental Health Research Grants	000	2	8/28/2023	NON-COMPETING CONTINUATION	$47,194
														Subtotal = $47,194

Issue Date FY: 2022 ( Subtotal = $46,252 )
2022	2022	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Mental Health Research Grants	000	1	3/25/2022	NEW	$45,536
2022	2022	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Mental Health Research Grants	002	1	7/18/2022	NEW	$0
2022	2022	NEW YORK UNIVERSITY	550 1ST AVE	NEW YORK	NY	10016	NEW YORK	USA	Mental Health Research Grants	001	1	7/18/2022	NEW	$716
														Subtotal = $46,252

Grand Total All Awards = $57,922

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How does implementation of Pay-for-Performance and Collaborative Care impact utilization and health outcomes for Medicaid Behavioral Health patients

Award Number: F30MH127905

ORGANIZATION: NATIONAL INSTITUTE OF MENTAL HEALTH

OPDIV: NIH

AWARD CLASS: DISCRETIONARY

AWARD ACTIVITY TYPE: FELLOWSHIP/SCHOLARSHIP/STUDENT LOANS

PERIOD OF PERFORMANCE START DATE: 09/28/2022

PERIOD OF PERFORMANCE END DATE: 07/22/2024

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