title: Paying for Early Interventions in Psychoses: A Three-Part Model.
abstract: Widespread dissemination of early interventions for psychosis, such as the intervention offered in the RAISE study (Recovery After an Initial Schizophrenia Episode), requires a funding mechanism that is both compatible with approaches already used by payers and generates incentives for providers that promote the desired behaviors. The authors propose a funding model with three components: a prospective per-case payment made conditional on patient engagement in treatment, a per-service component to cover the costs of clinical services, and an outcome-based component conditional on achieving measurable outcome milestones. The authors describe the components and how such a payment mechanism might be implemented.
authors.affiliation: Dr. Frank and Dr. McGuire are with the Department of Health Care Policy, Harvard Medical School, Boston. Dr. Frank is currently Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, Washington, D.C. Dr. Glied is with the Wagner School of Public Service, New York University, New York City. Send correspondence to Dr. McGuire (e-mail: mcguire@hcp.med.harvard.edu ). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column. This column is part of a special section on RAISE and other early intervention services.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Frank
authors.affiliation: Dr. Frank and Dr. McGuire are with the Department of Health Care Policy, Harvard Medical School, Boston. Dr. Frank is currently Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, Washington, D.C. Dr. Glied is with the Wagner School of Public Service, New York University, New York City. Send correspondence to Dr. McGuire (e-mail: mcguire@hcp.med.harvard.edu ). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column. This column is part of a special section on RAISE and other early intervention services.
authors.forename: Sherry A
authors.initials: SA
authors.lastname: Glied
authors.affiliation: Dr. Frank and Dr. McGuire are with the Department of Health Care Policy, Harvard Medical School, Boston. Dr. Frank is currently Assistant Secretary for Planning and Evaluation, Department of Health and Human Services, Washington, D.C. Dr. Glied is with the Wagner School of Public Service, New York University, New York City. Send correspondence to Dr. McGuire (e-mail: mcguire@hcp.med.harvard.edu ). Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column. This column is part of a special section on RAISE and other early intervention services.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: McGuire
mesh_terms: D003695:Delivery of Health Care / Q000191:economics*; D061345:Early Medical Intervention / Q000191:economics*; D006801:Humans; D018803:Models, Economic; D011618:Psychotic Disorders / Q000628:therapy*; D012559:Schizophrenia / Q000628:therapy*