A Partnership to Develop Behavioral Health Quality and Performance Measures.

The New York State Medicaid program is pursuing reforms that would shift reimbursement from fee-for-service to value-based models. Behavioral health populations and services are key to these reforms, but important gaps exist in the breadth and relevance of available quality measures for the behavioral health field. This column describes how the state addressed these gaps by using both inter- and intra-agency collaborations.

New York State Medicaid Reforms: Opportunities and Challenges to Improve the Health of Those with Serious Mental Illness.

Individuals with serious mental illness face multiple barriers to accessing care and experience disproportionately poor health outcomes. Starting in 2011, New York State undertook a series of major reforms of its Medicaid system designed to address these concerns. In this commentary we review three reforms that aim to change the way New York Medicaid is delivered and experienced, especially for underserved individuals with SMI: Health Homes, Behavioral Health Managed Care, and the Delivery System Reform Incentive Payment Program.

Changes in Percutaneous Coronary Interventions Deemed "Inappropriate" by Appropriate Use Criteria.

Background: Recent studies have demonstrated relatively high rates of percutaneous coronary interventions (PCIs) classified as "inappropriate." The New York State Department of Health shared rates with hospitals and announced the intention of withholding reimbursement pending demonstration of clinical rationale for Medicaid patients with inappropriate PCIs.

Objectives: The objective was to examine changes over time in the number and rate of inappropriate PCIs.

Guillain-Barré syndrome associated with immune reconstitution.

We report a case of acute Guillain-Barré syndrome (GBS) associated with a prompt and vigorous immune reconstitution and decrease in the virus load noted during treatment with a potent regimen of highly active antiretroviral therapy. We hypothesize that GBS may have been due to an aberrant immune response or an adverse drug reaction in association with preexisting peripheral neurologic disease.