Implementation of the Levels of Care (LOC) Payment Model in King County During the COVID-19 Pandemic: The Provider Perspective

Abstract

The LOC payment model was implemented in King County in July of 2020. Based on a Population Health Stratification Model (PHSM), the LOC payment model was developed with the intention of benefiting both the client and provider through a more accurate identification of the appropriate level of care and payment aligned with service intensity. Given the timing of implementation of the LOC payment model, it is likely that the co-occurrence of the pandemic had an impact on the ability of providers to adapt to the new model. Moreover, changes in policies or procedures that occurred in response to both the payment model and the pandemic are thought to have had an additional impact on the experience of providers with this new model. This research sought to understand the barriers and facilitators that impact the experience of behavioral health providers in adapting to the LOC payment model, including those that are a result of changes that occurred in response to the pandemic both organizationally and outside of the organization. The researcher utilized a case study qualitative research design, which included a brief electronic survey, individual interviews, various publications, and recorded webinars to understand the experiences of providers responsible for counseling, therapy, case management, or peer support services in King County. Ultimately, this study resulted in three key themes that demonstrate some of the challenges and facilitators that providers in King County have experienced in relation to the implementation of the LOC payment model and the co-occurrence of the COVID-19 pandemic. Additionally, this research informs recommendations to alleviate some of the observed challenges.