ETPS

PLEASE NOTE: This page is not continuously updated - mareynolds@odmhsas.org.

Enhanced Tier Payment System (ETPS) - Pay for Performance

Overview: The Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS) designed a performance outcomes payment plan, the Enhanced Tier Payment System (ETPS), with an overarching goal to proactively increase the recovery of Oklahomans from mental illness and substance abuse. Two primary objectives are 1) improve outcomes/access and, 2) creatively pay for outcomes with no additional state funds.

Initial Planning: ODMHSAS developed six measures that guide positive outcomes for consumer recovery. In addition, the ETPS was approved by the Center for Medicare and Medicaid Services (CMS) which then allowed Oklahoma to receive federally-matched funds for the project. For every state dollar contributed to the outcome measures, the federal government contributes $1.93, a match rate of 65.9%. With federally matched funds, we are able to turn roughly $2,000,000 into $6,000,000 and return that to communities to provide data-driven, research-based recovery outcomes to improve the lives of Oklahomans.

Report: The Oklahoma Enhanced Tier Payment System: Leveraging Medicaid to Improve Mental Health Provider Performance and Outcomes

Presentation: Webinar slides presented on NASMHPD Meet Me Call on 12/15/2016

Presentation: Webinar presented to State Mental Health Commissioners/Directors, NASMHPD’s Financing and Medicaid Division on 7/26/2012.

Charts: Measures by Provider by Month

Poster: Presented at NRI Data Conference in 2009 (won 1st place!)

Benchmarks were established for the measures based on data from a previous six-month time period and knowledge of best practices. The "Access to Treatment" measure is determined through “secret shopper” phone calls made to the facilities. Those reports are not included below.

Funding is allocated based on number of clients served and agency performance on each measure. Facilities may earn zero dollars, 50% of their allotment, 100% of their allotment, or more than 100% of their allotment depending on where each lands in relation to the benchmark.

The reports which end in 'Export', have detailed customer information. The reports are viewable in our secure website, but not here. Providers are able to export the data to Excel. The report ending with 'Detail' actual allow providers to drill down into more detail information. This gives providers a way to account for EVERY person included in each measure, plus enough detail information to understand why or why not a person was included, excluded, positive or negative.

CAR Interpersonal