New Incentives to Engage Members in Behavioral Health
Date: 07/23/19
Sunrise, Florida
We appreciate the partnership we have with you to provide behavioral health care for our members. We look forward to strengthening our partnership this year to further improve health outcomes and close care gaps for our members, your patients.
To support our shared goal of engaging our members to get timely care and recommended monitoring tests, we are excited to announce a new Medicaid incentive program for behavioral health providers. Starting July 1, 2019, we will offer two incentive payments tied to follow-up visits after a hospitalization and monitoring children and adolescents who take antipsychotics.
We realize that proactively engaging our members in needed mental health services can take administrative time and effort. This program is designed to support you in these proactive efforts. It rewards you for engaging our members in timely follow-up care after an inpatient admission, and for ensuring that evidenced-based guidelines are used for monitoring children and adolescents who are taking antipsychotic medications.
As a valued behavioral health provider, you are automatically enrolled in this new incentive program. Payments will be calculated by Sunshine Health based on claims, when care is provided as noted:
| MEASURE | DESCRIPTION | INCENTIVE AMOUNT |
|---|---|---|
| Follow-up after hospitalization for mental illness or intentional self-harm | Paid after a claim has been received for an outpatient visit with a mental health practitioner within seven (7) days of the date of discharge from a behavioral health acute inpatient facility for members ages 6 and older. | $100 |
| Metabolic monitoring for children and adolescents on antipsychotics | For members ages 1-17 who have two or more antipsychotic prescriptions filled of the same or different medications and claims are received for both:
| $200 |
Behavioral Health Provider Incentive Program webinars
Our OnDemand Webinars are available any time.
- Register for the Oct. 15, noon-1 p.m., BH Provider Incentive Training webinar.
- Register for the Oct. 24, 6:30-7:30 p.m., BH Provider Incentive Training webinar.
- Register for the Nov. 7, noon-1 p.m., BH Provider Incentive Training webinar.
- Register for the Nov. 13, 6:30-7:30 p.m., BH Provider Incentive Training webinar.
If you have questions, please reach out to your Provider Partnership Management (PPM) staff or contact Provider Services at 1-844-477-8313. We are here to help, Monday–Friday 8 a.m. to 8 p.m.