CHC Behavioral Health Data Febr brua uary y 13 13, , 20 2020 - - PowerPoint PPT Presentation

CHC Behavioral Health Data Febr brua uary y 13 13, , 20 2020 20

1

Abigail Coleman/Director Program Analytics Office of Long-Term Living Department of Human Services Charles Klinger/Systems Division Director Office of Mental Health and Substance Abuse Services Department of Human Services

OL OLTL TL and and OMH OMHSAS SAS Activities Activities

2

❑ Established OLTL/OMHSAS Monthly Meetings ❑ Coordinated Joint Meetings between CHC-MCOs, Dual Special Needs Plans (D-SNPs) and BH-MCOs ❑ CHC Performance Improvement Projects (PIPs) (CY 2020-2023)

2/14/2020

Clinical: Strengthening Care Coordination

CHC Goal: Strengthen coordination of LTSS and other types of health care including all Medicare and Medicaid services for dual eligible individuals ▪Involves and promotes coordinating care between CHC-MCOs and D-SNPs for nursing facility, acute care, behavioral health

Non-Clinical: Transitioning from Nursing Facility to the Community

CHC Goal: Enhance Community Based Living Opportunities

• Promotes Coordinating care between CHC-MCOs and D-SNPs for nursing facility and behavioral health

The he numbe number r of

• f Pr

Projected

• jected C

CHC HC Par articipants w ticipants who ho had had a c a claim wit laim with h a primar a primary y BH BH dia diagno gnosis sis in 2017 in 2017

3 2/14/2020

Total Population Primary BH Diagnosis Medicaid BH Encounters Only 207,685 35,757 17.22% FFS Medicare Claims Only 83,528 40.22% Unduplicated Medicare and Medicaid 89,227 42.96%

Medica Medicaid Onl id Only y Se Services vices

4

• 7.87% of individuals enrolled in a Community HealthChoices

Managed Care Organization (CHC-MCO) received a Medicaid Only service in 2018

• Mental Health Crisis Intervention
• Methadone Maintenance
• Mobile Mental Health
• Peer Support Services
• Targeted Case Management
• In comparison to Behavioral Health (BH) HealthChoices 6.78% of

individuals enrolled in a Behavioral Health Managed Care Organization (BH-MCO) in a Southwestern County received at least

• ne of these services in 2018

2/14/2020

The he nu numbe mber r of

• f ind

individua ividuals ls pe per 1,00 r 1,000 0 CHC CHC en enrolled

• lled

by by CHC CHC Pop

• pula

ulation tion Gr Grou

• up

p th that t rec eceiv eived ed a Med a Medicaid icaid Onl Only y Ser Service vice in 201 in 2018 8 (Sout (Southw hwes est t on

• nly)

y)

5 2/14/2020

CHC Population Group Total number of individuals that received the service Number of Individuals per 1,000 enrolled by CHC Population Group Nursing Facility Ineligible (NFI) 6,294 66.12 Home and Community Based (HCBS) Duals 649 6.82 Long Term Care (LTC) Duals 417 4.38 HCBS Non-duals 332 3.49 LTC Non-duals 136 1.43

The he nu numbe mber r of

• f ind

individua ividuals ls pe per 1,00 r 1,000 0 CHC CHC en enrolled

• lled

by by CHC CHC MCO MCO th that t rec eceiv eived ed a Med a Medicaid icaid Onl Only y BH BH Ser Service vice in 201 in 2018 8 (Sout (Southw hwes est t on

• nly)

y)

6 2/14/2020

CHC MCO Total number of individuals that received the service Number of Individuals per 1,000 enrolled by CHC-MCO UPMC COMMUNITY HEALTHCHOICES 4,207 44.20 PA HEALTH AND WELLNESS 2,048 21.52 AMERIHEALTH CARITAS 1,593 16.74

The he nu numbe mber r of

• f ind

individua ividuals ls pe per 1,00 r 1,000 0 CHC CHC en enrolled

• lled

rec eceiving eiving th the e follo

• llowing se

wing service vices s in 201 in 2018 8 (Sout (Southw hwes est t

• n
• nly)

y)

7 2/14/2020

BH Service Total number of individuals that received the service Number of Individuals per 1,000 CHC enrolled Mental Health Crisis Intervention 2,333 24.51 Methadone Maintenance 1,238 13.01 Mobile MH 361 3.79 Peer Support Services 926 9.73 Targeted Case Management 4,418 46.41

QUESTIONS

8