Last April 2016, the Washington State Health Care Authority (HCA) www.hca.wa.gov launched their Fully Integrated Managed Care (FMIC) program in partnership with Clark and Skamania counties in Southwest Washington.
For the first time, Washington State Medicaid beneficiaries have access to the full continuum of physical health, as well as Substance Use Disorders (SUD) and mental health services through a managed care plan of their choice.
Medicaid beneficiaries can be transitioned to coverage by one of two fully-integrated managed care plans such as Molina Healthcare of Washington (MHW) www.molinahealthcare.com or Community Plan of Washington (CHPW) www.chpa.org.
Also, Washington State HCA created the Behavioral Health Services Only (BHSO) program www.hca.wa.gov/assets/program/bh-aso_factsheet.pdf. Through this program, Medicaid clients get Medicaid coverage for their specialty mental healthcare and SUD treatment which is now called behavioral healthcare.
The goal during the first 90 days was to successfully transition behavioral health provider contracts and payments from the county and Regional Support Networks (RSN) to CHPW, Molina, and Beacon Health Options to ensure continuity of care and access to services for Medicaid beneficiaries.
HCA and Beacon Health Options www.beaconhealthoptions.com launched a regional crisis response system to replace and improve on the previous mental health crisis system managed through the state’s RSNs.
The recent HCA report “Delivery of Whole-Person Care in Southwest Washington” analyzed the results of the first 90 days for the State’s FMIC program. The report concludes that the FIMC program achieved success in the first 90 days and met its intended goals.
The report also concluded that the first 90 days of implementation has not been without challenges. Some of these challenges resulted from back office changes and reconfigurations needed for behavioral health providers in order to transition to billing managed care organizations rather than the RSN or the county.
The report also shows that these challenges are being addressed rapidly and collaboratively between the provider community, managed care organizations, and the state. They have not impeded access to care for clients. Lessons learned in Southwest Washington will be applied going forward as the state transitions to full integration between now and 2020.
Go to www.hca.wa.gov/assets/program/early-adopter-report.pdf to view the “Delivery of Whole-Person Care in Southwest Washington” report. For more information, email earlyadopterquestion@hca.wa.gov.