Abstract：
In 2017, the Certified Community Behavioral Health Clinic (CCBHC) demonstration was implemented in New York State to redesign care delivery and financing for behavioral health services. Although CCBHC primarily targeted Medicaid patients, it was hypothesized that the clinic-level benefits of CCBHC were expected to impact even non-Medicaid patients treated in CCBHCs. To test this hypothesis, this study conducted a health insurance claims data analysis of non-Medicaid (ie, commercial and Medicare) patients with severe mental illnesses, comparing a cohort of CCBHC-treated patients with a propensity score-matched comparison cohort of patients treated by non-CCBHC clinics on rates of mental health service utilization, hospitalization, and emergency department (ED) visits. The data suggested CCBHC was associated with more than 10% increase in outpatient mental health service utilization by the patients\' second year of CCBHC exposure, accompanied by similarly significant reductions in the rates of all-cause ED visits and non-psychiatric hospitalization. These findings suggest that for behavioral health clinics that serve a sufficiently large population of Medicaid, the impact of innovative clinical redesign attributable to CCBHC is likely to extend to all patients treated by them.
摘要：
2017年，在纽约州实施了认证社区行为健康诊所（CCBHC）演示，以重新设计行为健康服务的护理服务和融资。虽然CCBHC主要针对医疗补助患者，据推测,CCBHC的临床水平获益预计甚至会影响接受CCBHC治疗的非医疗补助患者.为了检验这个假设，这项研究对非医疗补助(即，商业和医疗保险)患有严重精神疾病的患者，比较一组CCBHC治疗的患者与非CCBHC诊所治疗的患者的倾向评分匹配的比较队列的精神卫生服务利用率，住院治疗,急诊（ED）就诊。数据表明，CCBHC与患者接触CCBHC第二年门诊精神卫生服务利用率增加10%以上相关，伴随着全因ED就诊率和非精神病住院率的显著降低。这些发现表明，对于为足够多的医疗补助人口服务的行为健康诊所来说，CCBHC引起的创新性临床重新设计的影响可能会扩展到所有接受其治疗的患者.
