Molina and Fully Integrated Managed Care in Southwest Washington September 14 th 2016 | Presented by: Ian Parham
Molina’s History Founded in 1980 by Dr. C. David Molina Single clinic Commitment to provide quality healthcare to those most in need and least able to afford it National company that touches over 3.5 million Medicaid beneficiaries 28 states, 2 commonwealths + Washington DC 2
Mission Vision To provide quality We envision a future health care to people where everyone receiving government receives quality assistance health care
Recognized for Quality, Innovation and Success Molina Healthcare, Inc. Molina Healthcare plans have been ranked among America’s top Medicaid plans by U.S. News & World Report and NCQA FORTUNE 500 Company by Fortune Magazine Business Ethics magazine 100 Best Corporate Citizens Alfred P. Sloan Award for Business Excellence in Workplace Flexibility in 2011 Ranked as the 2 nd largest Hispanic owned company by Hispanic Business magazine in 2009 Recognized for innovation in multi-cultural health care by The Robert Wood Johnson Foundation Awarded NCQA Multicultural Healthcare Distinction 2015 Dr. J. Mario Molina, CEO of Molina Healthcare, recognized by Time Magazine as one of the 25 most influential Hispanics in America 4
Molina in Washington 682,000 Members as of February 2016 • 648,000 Medicaid members • 10,000 Medicare (DSNP) • 24,000 Exchange Serving WA for more than 30 Years NCQA accredited • Statewide: 37 of 39 counties 83,000 members in Clark County, 80% del total in Medicaid Highest percentage of members joining by Choice in the County (75%) In January we welcomed all Medicaid Members formerly with Columbia United Providers CUP 5
Behavioral Health Integration
Current State – Fragmented Financing and Care 7
Future State – Integrated Financing = Integrated Care 8
What Does Better Look Like? Better Triple Aim integration Better of medical care Better Better Better fragmented and identification inclusion of health systems outcomes and treatment Social outcomes through care for people of behavioral determinants coordination living with health of Health Lower total – no falling chronic conditions in cost of care through mental primary care cracks illness Better Patient/ Provider experience 9
Benefits and Services
Provider Network Primary Care • Integrated Delivery Systems (Legacy Health, Peace Health) • Primary Care Clinics (i.e. Pediatrics, Family Practice, Internal Medicine, Naturopath) Mental Health • Inpatient Psychiatric Hospitals – MCOs do not administer this benefit • Community Mental Health Agencies • Behavioral Health Providers-Group Practices • Individual Behavioral Health Providers Substance Abuse • Substance Use Disorder (SUD)/ Chemical Dependency Agencies • Inpatient and Outpatient Treatment • Involuntary and Voluntary Facilities Community Providers • Beacon Health- Behavioral Health Administrative Services Organization (BH-ASO) for providing crisis service response 24 hours a day/7 days a week/365 days a year 11
Care Management Programs Community Based Face to In person and Face Care Telephonic Telephonic Coordination Telephonic 24/7 Nurse Case Disease Transitions of Advice line CHW Management Management Care Health Homes 12
Molina Healthcare Virtual Care (MVC)
My Molina – Member Services Molina Healthcare is increasing services to members through their mobile phones • “My Molina” portal allows members to search for a doctor, change doctors • Information on medications, service history, etc. • Molina members have access and control over their health information • Consent for sharing information- test launch in Clark County 14
Role in the Community
Community Engagement • A resource about all things Medicaid • Events that promote health / wellness • We know how to help and get help • Sponsorship with / for affinity orgs • Encourage people to take action • Employee Volunteer programs (VTO) Community Education, Education, Community Outreach, Involvement Outreach, Involveme and and nt and and Advocacy Sponsorshi Advocacy Sponsorship p • Promoting good health Enrollment Plan Enrollment • Supporting Community Based and and Organizations Retention Access to Care • Sharing knowledge to increase access to healthcare • Certified Application Counseling, Enrollment • Eligibility information and assistance • Outreach Call Center = 800-294-8620 • Apple Health Renewals support 16
Out and About! • Every year Molina Healthcare joins more than 1,000 member facing events and more than 800 meetings with community helpers and influencers across the state of Washington • These events offer a unique opportunity to really engage with communities, provide education in healthy living, and answers about health coverage and the healthcare systems in WA • Molina ´ s Community Engagement team is local to many regional communities and also travels to remote locations providing information and outreach 17
Local Community Partnerships • More than 70 events and community meetings with key local Community Based Organizations in Clark County, through October. • “Community Champions Awards” , a yearly celebration of outstanding community volunteers, has recognized three Clark County residents in recent years: • April Herndon, SeaMar (2013) • Dr. Susan Davis, Free Clinic of SWWA (2015) • David Bilby, Go Connect (2015) • Active presence in regional health focused conferences, like “Integrated Care Conference” , “WA Behavioral Health” and “Latino Center for Health” in Vancouver. • In partnership with The Molina Foundation , over 2,000 books donated this year to local schools including Marshall, Pioneer, Sara J. Anderson, and Walnut Grove 18
Your Extended Family! • Healthcare services with focus on our communities • Grassroots Community presence and engagement • Contact Information: – Member Services: (800) 869-7165 – Questions about Medicaid Eligibility: (800) 294-8620 – Community Engagement: • Clark County: Carlos Mejía Rodriguez Carlos.mejiarodriguez@molinahealthcare.com 360-489-7969 • Office Coordinator: Katty Nazario Vásquez Katterine.Nazario-Vasquez@MolinaHealthCare.Com 425-398-2659 • State Director: Jorge Rivera Jorgearturo.rivera@molinahealthcare.com 425-424-7119 19
Questions? 11 20
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