Starting in 2019, Apple Health (Medicaid) plans will cover behavioral health treatment services, in addition to the already covered physical health services. Read on to find out what this means for Apple Health clients and what you need to know to answer their questions.
Read MoreSlides from the MCO Meet & Greet on Sept. 12, which include contact information for MCO representatives.
Read MoreClaims and Encounters Delegation files from each of the managed care organizations (MCOs) in our region can be found here.
Read More837 Batch Sample files from each of the managed care organizations (MCOs) in our region can be found here.
Read MoreFor easy reference BHT is collecting Companion Guides from each of the managed care organizations (MCOs) in our region onto this page. Stay tuned for more updates.
Read MoreThe HCA has created a guidance document to help with question around the submission of demographic data (or what they call non-encounter data or native transactions.)
Read MoreNorth Central ACH hosted a panel discussion to share their region's knowledge and experiences regarding IMC transitioning. Below are the key takeaways BHT staff noted from the discussion.
Read MoreBHT and our Partners have been busy this spring and summer. Read on to find out what’s happening at our ACH!
Read MoreThree workgroups have been established to help move the work forward.
Early Warning System: Develop recommendations for an Early Warning System that allows a feedback loop and triage process to identify and resolve system issues as they arise.
IT/EHR: Identify and resolve IT/EHR issues including but not limited to MCO/ASO billing capacity, EHR compatibility, provider data reporting requirements, technical assistance needed by providers.
Communications: Provide recommendations and work to engage the consumer sector in system change efforts related in integrated managed care. Ensure that consumers maintain confidence and continuity in the care they are receiving. Ensure smooth transition to IMC through the development of clear communication materials, client notifications, and transparent transition processes.
Composition: Open to any Spokane, Pend Oreille, Stevens, Ferry, Lincoln, and Adams stakeholders who are interested in participating. Representation from the following organizations will be strongly encouraged.
Authority: These are not a decision-making bodies, but will provide recommendations that will ensure concerns surrounding IMC are addressed and resolved in the Spokane region.
Meetings: Held no less than monthly through January 2019. All meetings will have an option to participate via teleconference for those unable to attend in person. BHT staff, in collaboration with workgroup members, HCA and the SCRBHO, shall be responsible for establishing the agenda. Notes for all meetings will be provided by BHT staff within two weeks of each meeting.
This list is provided by the Health Care Authority (HCA). You can view the entire presentation here.
The Health Care Authority (HCA) has announced the selection of Managed Care Organization (MCO) plans from its recent round of Medicaid procurement.
Read MoreAs many of the regions around the state prepare for the transition to integrated managed care, our friends at the HCA thought it would be helpful to compile lessons learned and best practices from the first two regions.
Read MoreIn 2014 the Washington state legislature passed 2SSB 6312 that requires integration of behavioral health benefits into the Apple Health managed care program by 2020. Additionally, this provided a road map for integration, that included the transition from a Regional Service Network to Behavioral Health Organizations. Spokane County serves as our region’s Behavioral Health Organization and has done a tremendous job integrating our mental health and substance abuse services through Adams, Lincoln, Stevens, Pend Oreille, Ferry, and Spokane Additionally, Okanogan county selected to receive BHO services from Spokane but will ultimately be transitioned to North Central no later than January 1, 2020.
Additionally, the legislation provided a provision for early and mid-adopter regions. Southwest, comprised of Clark and Skamania counties, were the only region in the state to select to be an early adopter. This region launched fully integrated managed care in April 2016 after a RFP process that selected Molina and Community Health Plan of Washington.
Late in 2016, North Central, comprised of Chelan, Douglas and Grant counties, announced their intention to be mid-adopters. North Central is currently in their RFP process, all 5 Managed Care plans are applying and we expect to have an announcement in mid-May of the selected 2-3 plans.
On April 10, the HCA released new incentive information for region’s willing to be mid-adopters. For our region, this would mean $8.7 million dollars for investment in providers to prepare for fully integrated managed care (FIMC). In order to trigger the investment, step one is for each county’s Commissioners to submit a binding letter of intent by September 1, 2017.
There is current legislative movement occurring, in which the Spokane BHO is active, to shift the integration deadline beyond 2020, carve out a specific role for BHOs moving forward, and provide a mechanism for BHOs to have a right of first refusal for the Behavioral Health Administrative Role that will deliver crises services, administer certain non-Medicaid funding sources and other negotiable regional functions. Additionally, the state legislature still needs to adopt a policy to move current funding from DSHS to Health Care Authority. This is currently still active legislation.
BHT Board Decision
As noted above, this is a decision for each of our region’s County Commissioners to make. BHT could adopt a policy and direct BHT staff to provide information and advocacy to partners and Commissioners to assist in encouraging our region to be a mid-adopter of FIMC.
APPROVED MOTION:
To actively support moving the BHT ACH region to FIMC by 2019 in order to trigger a $8.7-million-dollar investment and accelerate our efforts to move to whole person care.
We have decided to hold off on starting out Integrated Care work group until September. Our Social Determinants and Population Health work groups are identifying strategies that address health upstream, and our ACH Project Team is exploring the Pathways HUB model to see if it fits for our regional project. We feel the decisions made by these groups will be crucial in shaping our Integration strategies, so we've decided to delay. If you want to be involved in the Integrated Care work group once if forms, shoot us an email.
Integrated Care
