Payment Reform Rate Structure

SAPC’s Value-Based Incentives (VBI) are designed to support and advance the implementation of CalAIM’s Behavioral Health Payment Reform by shifting from primarily cost-based practices to fee-for-service and value-based practices. This approach encourages the adoption of innovative organizational practices, integration of data into decision-making, and a focus on service quality and outcomes across the specialty SUD treatment continuum.

These incentives are implemented alongside SAPC’s tiered, actuarially sound rate structure, which scales based on the number of levels of care a provider agency delivers (see image to the right).

Value-Based Incentives

SAPC has developed a VBI Package in which the majority of funds are distributed upon achieving specific performance metrics or submitting required deliverables. The activities are structured to assess whether provider agencies invest in and deliver outcome-focused services that further quality care. VBI’s core focus areas are: Finance and Business Operations, Workforce Development, and Access to Care.

Finance and Business Operations
View Resources for Finance & Business

Workforce Development
View resources for Workforce Development

Access to Care
View resources for Access to Care

Resources

Guidance Documents
Access Incentive Package, VBI Invoice and other guidance documents for use

Upcoming Trainings
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Deadlines & VBI Communications
View upcoming at-a-glance due dates