TY - JOUR
AU - R. E. Stewart
AU - S. C. Marcus
AU - T. R. Hadley
AU - B. M. Hepburn
AU - D. S. Mandell
A1 - 
AB - OBJECTIVE: Despite the critical role behavioral health care payers can play in creating an incentive to use evidence-based practices (EBPs), little research has examined which incentives are used in public mental health systems, the largest providers of mental health care in the United States.     METHODS: The authors surveyed state mental health directors from 44 states about whether they used any of seven strategies to increase the use of EBPs. Participants also ranked attributes of each incentive on the basis of key characteristics of diffusion of innovation theory (perceived advantage, simplicity, compatibility, observability, and gradually implementable) and perceived effectiveness.     RESULTS: Almost three-quarters of state directors endorsed using at least one financial incentive; most paid for training and technical assistance. Few used other incentives. Strategies perceived as simple and compatible were more readily adopted. Enhanced rates and paying for better outcomes were perceived as the most effective but were the least deployed, suggesting that simplicity and organizational compatibility may be the most decisive factors when choosing incentives.     CONCLUSIONS: Payers are not using the incentives they perceive as most effective, and they are mostly using only one strategy for reasons of simplicity and compatibility. Future work should focus on barriers to measurement that likely hinder the adoption and implementation of paying for better outcomes and enhanced reimbursement rates, with the ultimate goal of measuring the effectiveness of incentives on EBP implementation efforts.
BT - Psychiatric Services
C5 - Healthcare Policy
CP - 6
DO - 10.1176/appi.ps.201700508
IS - 6
JF - Psychiatric Services
N2 - OBJECTIVE: Despite the critical role behavioral health care payers can play in creating an incentive to use evidence-based practices (EBPs), little research has examined which incentives are used in public mental health systems, the largest providers of mental health care in the United States.     METHODS: The authors surveyed state mental health directors from 44 states about whether they used any of seven strategies to increase the use of EBPs. Participants also ranked attributes of each incentive on the basis of key characteristics of diffusion of innovation theory (perceived advantage, simplicity, compatibility, observability, and gradually implementable) and perceived effectiveness.     RESULTS: Almost three-quarters of state directors endorsed using at least one financial incentive; most paid for training and technical assistance. Few used other incentives. Strategies perceived as simple and compatible were more readily adopted. Enhanced rates and paying for better outcomes were perceived as the most effective but were the least deployed, suggesting that simplicity and organizational compatibility may be the most decisive factors when choosing incentives.     CONCLUSIONS: Payers are not using the incentives they perceive as most effective, and they are mostly using only one strategy for reasons of simplicity and compatibility. Future work should focus on barriers to measurement that likely hinder the adoption and implementation of paying for better outcomes and enhanced reimbursement rates, with the ultimate goal of measuring the effectiveness of incentives on EBP implementation efforts.
PY - 2018
SP - 685
EP - 688
EP - 
T1 - State Adoption of Incentives to Promote Evidence-Based Practices in Behavioral Health Systems
T2 - Psychiatric Services
TI - State Adoption of Incentives to Promote Evidence-Based Practices in Behavioral Health Systems
U1 - Healthcare Policy
U2 - 29493412
U3 - 10.1176/appi.ps.201700508
VL - 69
Y1 - 2018
ER -