Network designed to ease integration of health care
May 24th, 2018
Spokane nonprofit Excelsior Youth Center has teamed with two companies to establish Integrated Managed Care Collaborative, a new network tool aimed at helping behavioral health organizations prepare for the integration of health care in the Spokane region.
Located at 3754 W. Indian Trail Road on Spokane’s North Side, Excelsior serves youth and their families through a variety of behavioral health, education, and therapeutic recreation programs and services.
Andrew Hill, president at Excelsior, says, “We formed the IMCC (Integrated Managed Care Collaborative) as a way of helping providers prepare for a private integrated managed care system, develop billing services, and report patient data differently,” he says.
The two other companies involved in the network are Lakebay, Wash.-based Xpio Group Health LLC, and Nashville, Tenn.-based Qualifacts Systems Inc.
Xpio is a technology and behavioral health consulting firm that provides services to state and community behavioral health and human services organizations.
Qualifacts Systems is a technology company that builds and implements software services and web based electronic health records and billing systems for behavioral health and human services providers.
Hill says the collaborative was formed to aid the state Health Care Authority as it moves to meet legislative direction under Senate Bill 6312.
Signed into law in April 2014, the bill stipulates that by 2020, all regions of the state will need to transition to an integrated system for physical and mental health, as well as substance use disorder services in the Washington Apple Health program, which is funded through Medicaid.
Prior to April 2016, Hill says, substance use, mental health, and primary care services were each funded separately.
“Previously, mental health was funded through regional support networks. Substance-use care was funded by the state and directly contracted with providers, and primary care was funded separately,” he says.
He adds, “The state’s first step toward health care integration was to combine mental health and substance use services. Regional support networks were dissolved in favor of creating regional behavioral health organizations that have since been working to merge the two care types ahead of the overall integration requirement.”
Hill says behavioral health organizations have decisions to make about the timeline to adopt integrated managed care, and the Spokane County regional behavioral health organization, which includes Spokane and several other Eastern Washington counties, has agreed to become a mid-adopter beginning Jan. 1.
He says after that date, funding for all three services will be rolled into agreements Health Care Authority has with five managed care organizations: Amerigroup, Community Health Plan of Washington, Coordinated Care of Washington, Molina Healthcare, and UnitedHealthcare Community Plan.
At least four managed care organizations will be selected to serve Spokane and surrounding Eastern Washington counties.