Capacity of Medicaid Providers to Implement and Sustain Evidence-Based Practices for Behavioral Health Services, Louisiana, 2022.

Abstract

The Center for Evidence to Practice at Louisiana State University Health Sciences School of Public Health (hereinafter, the Center) is committed to strengthening the capacity of Medicaid providers to implement and sustain evidence-based practices (EBPs) for behavioral health services. With funding from the Louisiana Department of Health-Office of Behavioral Health, the Center conducted the EBP Capacity and Sustainability Funding Initiative to expand the use and accessibility of EBPs in Louisiana. This case study examined how targeted financial incentives and technical assistance supported clinicians in qualifying for, billing, and delivering 7 EBPs within Louisiana's Medicaid behavioral health system. Thirty EBP-qualified clinicians delivered 361 sessions to 93 clients during a 5-month funding period (March-July 2022) and earned $167 500 in incentives across 25 entities. A survey of these clinicians found that 96% (24 of 25) would recommend this type of incentive, reporting increased motivation, professional recognition, and capacity to grow their practices. However, Medicaid claims data showed that the use of EBP tracking codes decreased after the incentive period ended, suggesting that short-term funding alone was insufficient for long-term sustainability. Clinicians identified administrative and technical barriers, including inconsistent managed care organization requirements and nonstandardized billing processes. A simplified billing infrastructure and ongoing funding incentives are needed to reduce the administrative burden of billing and promote EBP implementation. Findings highlight the strengths and limitations of short-term incentive programs for advancing EBP delivery within a Medicaid system.