RWJF HD4A Grant: Examining Negotiated Rates for Behavioral Health and Primary Care

The Robert Wood Johnson Foundation awarded the Research Consortium at VCHI a $100,000 Health Data for Action Grant to examine negotiated rates for behavioral health and primary care.

The project, “Examining Negotiated Rates for Behavioral Health and Primary Care Providers,” addresses information gaps policymakers confront regarding Medicaid and commercial reimbursement rates. The purpose of this study is to gain knowledge about how rates vary across payers, provider types, facility types, and across provider ownership structure and region. The goal of the project is to enable policymakers to evaluate existing payment policies and identify specific areas for targeted rate adjustments that would improve provider participation, promote equity, and improve access to critical services in disadvantaged regions or populations.

AcademyHealth provided access to data for the project. The Research Consortium at VCHI leveraged newly-released Transparency in Coverage (TiC) data from Mathematica Data Innovation Lab, as well as data from the Virginia All-Payers Claims Database (APCD) provided by Virginia Health Information (VHI). This novel data will allow for unprecedented comparison of Medicaid to commercial payer reimbursement rates.

This research is conducted in partnership with the College of William & Mary Tang Professor of Economics and Public Policy Jennifer Mellor, PhD, and George Mason University Associate Dean for Research of the College of Public Health Alison Evans Cuellar, PhD, MBA.