November 29, 2018

December 2018 Integrated Managed Care (IMC) Update

The Behavioral Health (BH) Providers have been busy this month preparing for January 1, 2019! During the November convenings, the BH Providers focused on testing with the Managed Care Organizations (MCOs), registering their National Provider Identifier (NPI) numbers with the Health Care Authority (HCA), and discussing contingency funds. The group also decided to bring in a consultant to troubleshoot and support BH Providers during the first year of IMC (details to be finalized within the next month).

Of the 17 BH Providers, 15 have signed the Greater Columbia Accountable Community of Health (GCACH) contract. Ten BH Providers were paid in full while the other five were paid for completion of their Maine Health Access Foundation (MeHAF) and the Billing IT Toolkit Self-Assessments. The Washington Financial Executor (WAFE) Portal will be down until December 28th. GCACH’s goal is to pay all BH Providers by January 1, 2019.

GCACH held three Provider Readiness Workgroup meetings in November: November 1, 2018; November 15, 2018; and November 29, 2018. During the first meeting, the Director and Chief Financial Officer (CFO) of Greater Columbia Behavioral Health, Troy Wilson, announced that the Behavioral Health Organization (BHO) will become the Behavioral Health Administrative Service Organization (BHASO) as of January 1, 2019—of which Troy Wilson will be the Director. Troy also addressed several questions from the BH Providers about the plans for the ASO. We also discussed some of the lessons learned from other integrated regions. 

During the November 15, 2018 Provider Readiness Workgroup convening, HCA discussed the Rapid Response Calls that will begin on January 2, 2019 as well as the Early Warning Indicators. The Rapid Response Calls will occur daily to check-in on emerging systemic issues or questions needing immediate attention. GCACH plans to ask the BH Providers to review the following the following indicators: number of screenings and the type of assessments conducted each month. Beginning in February 2019, monthly webinars will be conducted to review data collected from the indicator reports. Lastly, during the November 29, 2018 meeting, the group discussed the use of the contingency funds and the possibility of hiring a consultant for the BH Providers as they transition to IMC in 2019.

The Integrated Managed Care (IMC) Communications Workgroup Meeting was cancelled for November 2018. The next IMC Communications Workgroup is scheduled for December 11, 2018.

The Early Warning System (EWS) Workgroup met on November 13, 2018. During this meeting, the HCA updated the group on the provider metrics indicators. The HCA talked about monthly webinars and discussed demonstration slides. The group also discussed Rapid Calls that will begin on January 2, 2019. The EWS Workgroup decided the only indicators BH Providers must share are the number of screenings and the type of assessments. The next EWS Workgroup is scheduled for December 11, 2018.