CCBHC Model Puts ‘Building Blocks into Place for Value-Based Payment Success’

The Certified Community Behavioral Health Clinic (CCBHC) model has been shown to reduce hospitalizations, cut costs and improve employee recruitment and retention for participants. And on top of all that, it can also help set providers up for success in value-based care models.

“CCBHC funds can really help organizations put those building blocks into place for value-based payment success in the future,” Heidi Arthur, the principal of Health Management Associates (HMA), said. “We know that because they’re already demonstrating significant savings, and it’s those kinds of savings that really make the case for targeted investments under value-based payment arrangements.”

Arthur made those comments Thursday during a webinar hosted by her organization. HMA is a health care research and consulting firm that helps clients with a wide variety of projects, including CCBHC applications and implementation.


The CCBHC model was created back in 2014 as a Medicaid demonstration, which has been extended for select states through September 2023. It gives clinics higher reimbursements in return for offering a set of comprehensive care services for individuals with complex needs. Some of those services include 24-hour crisis care, as well as comprehensive outpatient mental health and SUD treatment.

Meanwhile, behavioral health providers who aren’t located in demonstration states can become CCBHCs by applying for special grants from the Substance Abuse and Mental Health Services Administration (SAMHSA), with the main difference being that grant money is capped and runs out after a certain amount of time.

CCBHCs make the perfect candidates for value-based care models because of the comprehensive services they provide, the savings they generate, the data they collect and the superior outcomes they deliver, according to Kristan McIntosh, a social worker and senior consultant at HMA.


“We see the CCBHC model as very much aligned with value-based payment,” McIntosh said during the virtual event. “These CCBHC expansion grant funds can support … providers to build capacity to move toward services and supports that are sustainable, which may be underneath the umbrella of value-based care.”

Value-based reimbursement is an exciting prospect for many behavioral health providers, as the space has historically been plagued by extremely low fee-for-service reimbursement rates. Value-based models, on the other hand, give providers the opportunity to be paid more for the high-quality outcomes they deliver.

“Alternate payment methodologies really are the wave of the future,” Arthur said, noting that value-based reimbursement is becoming “the dominant payment model” for Medicare, Medicaid and commercial insurers.

She’s not the only one who thinks so. In fact, 91% of payers believe alternative payment model activity will pick up in the future, according to survey results released by Health Care Payment Learning and Action Network (LAN) in 2019.

And CCBHCs nationwide are getting in on the action, Arthur explained, with about 43% of CCBHC already starting to negotiate alternate payment programs with private payers.

Currently, there are 431 CCBHCs and counting across 42 states, Washington, DC and Guam, according to the National Council for Mental Wellbeing. That includes clinics in the Medicaid demonstration, as well as SAMHSA grant recipients. While many of those clinics are new to the program thanks to a huge recent expansion in grant funding from SAMHSA, even freshman CCBHCs can take advantage of the value-based payment opportunities the model affords.

“Not only can you speak to what your organization is able to do, but you can also say, ‘Here’s a model that we’re doing. Here’s what’s been achieved elsewhere,’” Arthur said. “You can begin to leverage the success of those who have gone before you in order to make the case for what you want to be able to do with your own alternate payment programming.”

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