Table 1.

Updated List of Financing Strategies and Definitions

Financing Strategy	Definition
Fee-for-service reimbursement	Include the evidence-based treatment in an insurance provider or management organization’s fee-for-service list/formulary so that providers can receive reimbursement for providing that practice (see also: increased fee-for-service reimbursement)
Increased fee-for-service reimbursement rate	Increase insurance provider or management organization’s reimbursement rates to providers for the evidence-based treatment, relative to other services, in order to offset increased costs to providers for delivering that practice (also called an “enhanced rate”) (see also: standard fee-for-service reimbursement)
Removed/altered billing limits	Allow insurance payments to providers for services that are disallowed under typical billing limits (additional sessions, services for patients with designated diagnoses, etc.) when delivering the evidence-based treatment
Technical support for billing	Provide assistance (from insurance or a third party) to providers for preparing and successfully submitting claims for delivery of the evidence-based treatment
Pay-for-success (PFS) financing	Establish agreements in which private or nonprofit investors prospectively provide funding for providers to deliver the evidence-based treatment and in which a government entity provides a payout to the investors if preestablished outcomes or quality metrics are achieved in a designated period
Global budget allocations	When allocating government general funds, include funding in the overall annual budget of a state, county, or municipal agency to cover the costs of having the agency’s providers deliver the evidence-based treatment
Line-item budget earmarks	When allocating government general funds, include designated (protected or earmarked) funding in the annual budget of a state, county, or municipal agency to cover the costs of having the agency’s providers deliver an evidence-based treatment
Braided funding streams	Coordinate multiple funding sources across two or more government agencies to cover the costs of an agency’s delivering the evidence-based treatment, such that each individual funding source remains accounted for separately; generally established through annual budgets (see also: blended funding)
Contracts for EBTs	Award funding contracts from state, county, or municipal agencies to provider organizations that agree to deliver the evidence-based treatment
Inclusion in block grants	Allow payment to providers for delivering the evidence-based treatment using block grants, which provide a fixed amount of money to state, county, or municipal agencies to pay for a designated set of health services
Shifting funds between programs	Reallocate funds from other programs and practices, within or across state, county, or municipal agencies, to cover the costs of delivering the evidence-based treatment; often funds currently dedicated to services whose use is expected to decline due to the evidence-based treatment
Grant funding	Award grant funding from government or private funders to provider organizations that propose to deliver the evidence-based treatment
Fundraising and investor donations	Collect donations from private or nonprofit investors, including fundraising and philanthropy, that will be used by provider organizations to cover the costs of delivering the evidence-based treatment
Cost offset	State, county, or municipal funders directly pay for infrastructure (such as a dedicated intermediary organization) that supports the delivery of evidence-based treatments by providing training, technical assistance, and other nonmonetary resources to providers within a given jurisdiction
Credentialing/rostering providers	Establish between insurance provider or management organizations and training organizations agreements for evidence-based treatments in which designated providers are allowed to receive payment for the evidence-based treatment (often at an increased rate)
Blended funding streams	Combine multiple funding sources across two or more government agencies to cover the costs of an agency’s delivering the evidence-based treatment, such that all funding is accounted for together and no longer separable by source; generally established through legislative action (see also: braided funding)
Dedicated taxes	Collect a state, county, or municipal tax, then allocate the revenue from that tax to provider organizations that deliver the evidence-based treatment
Capitated or patient-based payments	Provide a set, prospective insurance payment to providers that is expected to cover all expenses for a given patient’s care (including increased costs of delivering the evidence-based treatment) in a designated period (see also: bundled or episode-based payments)
Pay-for-performance (P4P)	Provide a financial bonus (on top of other insurance payments) to provider organizations for achieving preestablished outcomes or quality metrics in a designated period, with bonuses sufficient to cover increased costs to providers associated with delivering the evidence-based treatment
Value-based purchasing	Provide insurance reimbursement to providers only when they achieve preestablished outcomes or quality metrics for a designated period, with reimbursement sufficient to cover increased costs to providers associated with delivering the evidence-based treatment
Government bonds	Issue state, county, or municipal bonds (securities) for purchase by private or nonprofit investors, then allocate the revenue from those bonds to provider organizations that deliver the evidence-based treatment
Vouchers for EBTs	Provide vouchers of a predetermined value that patients can redeem to receive the evidence-based treatment from providers, who are then repaid by the insurance or government payor that issued the voucher
Bundled or episode-based payments	Provide a set insurance payment to a group of providers that is expected to cover all expenses for a given diagnosis or episode of care (including increased costs of delivering and coordinating the evidence-based treatments across providers); can be prospective or retrospective payments (see also: capitated or patient-based payments)

Note. The original list of financing strategies and definitions was published in a scoping review (17); surface-level changes made to incorporate Survey 1 participant feedback are denoted with bold text. EBT = evidence-based treatment.

The original list of strategies and definitions was published under the terms of the Creative Commons Attribution 4.0 License

(https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction, and distribution of the work without further permission provided the original work is attributed.