Projects for Arizona Department of Health Services, Division of Behavioral Health Services

Encounter Validation Project

Service Category: External Quality Reviews and Other Independent Evaluations

B&A performed an analysis of the values of encounters submitted by the Regional Behavioral Health Associations (RBHA) to the ADHS/DBHS that support their capitation payments. The results of the independent audit resulted in repayments to the DBHS by one RBHA. B&A also developed a report tracking module for the DBHS to conduct the validations going forward.

HCBS Rate Setting – ADHS/DBHS

Service Category: HCBS Rate Setting

B&A performed an evaluation of the appropriateness of over 40 rates paid to providers by the Division of Behavioral Health Services. B&A conducted ongoing discussions with a multi-disciplinary team to review current independent rate models to modify the design to provide appropriate reimbursement for best practices. A provider cost survey was also conducted and analysis of these costs were used to justify the market-based rate models.

This project represented a rebase of the models originally completed by Gretchen Engquist in 2000-2001 prior to B&A’s formation.

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