Improving Medi-Cal Mental Health Services ITUP Pre-Conference - - PowerPoint PPT Presentation

Improving Medi-Cal Mental Health Services

ITUP Pre-Conference February 4, 2019

Catherine Teare, California Health Care Foundation Logan Kelly, Center for Health Care Strategies Alfredo Aguirre, San Diego County Kiran Savage-Sangwin, California Pan-Ethnic Health Network

$3.04 billion $1.77 billion $1.39 billion $1.31 billion $225.6 million $212.8 million $190.5 million $14.7 million Federal Mental Health Medicaid Matching Funds Mental Health Services Act 2011 Realignment 1991 MH Realignment Federal SAPT Block Grant Other (MH Block Grant, County MOE, County GF) Federal SUD Medicaid Matching Funds State General Fund

16%

*Amounts based on FY16/17 Estimated Behavioral Health Funding. Does not reflect projected increases in federal matching funds and state general fund spending on SUD services under the DMC-ODS. Source: CBHDA

37% 22% 17%

California County Behavioral Health Funding

3

National Overview of Physical and Mental Health Integration

Kathleen Gifford et al., States Focus on Quality and Outcomes Amid Waiver Changes: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2018 and 2019, Kaiser Family Foundation, 2018,.

 States are pursuing greater integration in financing, delivery, and coordination of mental and physical health services.  Increasing number of states are including specialty MH services in MCO contracts.

Coverage of Specialty Outpatient MH in Medicaid, 2018 Key Carved out into PHP

• r FFS (10)

Included in MCO (22) Varies (7)

4

Examples of State Approaches

Massachusetts: Community Partner Program and Medicaid ACOs

Behavioral Health Community Partners work with Medicaid ACOs to provide care management and coordination to individuals with BH needs.

New York: Health and Recovery Plans (HARPs)

Integrated MCOs serve general population, and manage separate specialty HARPs for individuals with SMI and SUD diagnoses.

Washington: Fully Integrated Managed Care

Initiated comprehensive carve-in approach with phased implementation based on region.

5

Key Components of State Approaches to Integration of Financing

 Phasing by population and/or region  Delegation  Number of plans available  Procurement of new or existing plans  Dually eligible beneficiaries  Management of non-Medicaid services  Management of services for non-Medicaid populations  Ensuring smooth system transition