Design of a Payment Decision-Support Tool for Coordinated Specialty Care for Early Psychosis.


Bao Y(1), Li Y(1), Jeng PJ(1), Scodes J(1), Papp MA(1), Humensky JL(1), Wall M(1), Lee R(1), Ancker JS(1), Pincus HA(1), Smith TE(1), Dixon LB(1).
Author information:
(1)Department of Population Health Sciences
(Bao, Jeng, Papp, Ancker) and Department of Psychiatry
(Bao), Weill Cornell Medicine, New York City; Department of Population Health Science and Policy and Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York City
(Li); New York State Psychiatric Institute, New York City
(Scodes, Humensky, Wall, Pincus, Smith, Dixon); Department of Psychiatry, Irving Medical Center
(Scodes, Humensky, Wall, Pincus, Smith, Dixon), and Department of Biostatistics, Mailman School of Public Health
(Wall), Columbia University, New York City; Silberman School of Social Work at Hunter College, City University of New York, New York City


A strengthened evidence base and earmarked federal funding have spurred the implementation of coordinated specialty care (CSC) for people experiencing early psychosis. However, existing funding mechanisms are insufficient and unsustainable to support population-wide deployment of CSC. This article describes the design framework of an innovative payment model for CSC that includes a bundled case rate payment and an optional outcome-based payment. To assist CSC payer and provider organizations in designing payment systems tailored to local preferences and circumstances, the research team is developing a decision-support tool that allows users to define design choices and provide input. The authors document the analytical algorithms underlying the tool and discuss how it could be further developed or expanded for CSC and other behavioral health interventions that feature an interdisciplinary team of clinicians and nonclinical professionals, public education and outreach, patient centeredness, and a recovery orientation.