Medicaid recipients to receive integrated physical and behavioral care

Patients on Medicaid (Apple Health) in Whatcom County will soon be able to access the health services they need with greater ease, as the state shifts toward an integrated care approach.

On July 1, Washington state changed the way it pays for the delivery of physical and mental health services for Medicaid recipients. The goal is to bring together the payment and delivery of physical and behavioral health services, along with mental health and substance-use disorder treatment.

“The goal around this initiative is to improve care coordination between primary care and behavioral health,” said Connie Mom-Chhing, director of fully integrated managed care at Community Health Plan of Washington (CHPW). “It’s an opportunity to achieve whole-person care.”

Behavioral health includes mental health and substance-use disorders. It’s a combination of outpatient services to include individual and group therapy, medication management, inpatient stays at psychiatric hospitals, services delivered in treatment facilities and peer support services.

In the past, behavioral health was managed separately. Medicaid clients had to navigate three separate systems in order to access the services they needed to keep their bodies and minds healthy. Primary care was managed by a managed care organization such as CHPW, substance use was managed by the county and mental health was managed by a regional support network, a separate entity located in each region. “It was a fragmented system,” said Mom-Chhing.

Now, all those services will be coordinated through one single system, which should lead to improved health outcomes, more streamlined services and better coordination of care from a patient’s primary care provider.

“Rather than having a separate insurance card for all three areas of care, you now have a single insurance card for all your health benefits,” said Mom-Chhing. “It’s streamlining the process, and it’s also combining the benefits into one, so that it’s more comprehensive.”

According to Mom-Chhing, different parts of the state have made the transition at different times. “Each region was given an opportunity to pick and choose whether to be an early-, mid- or late-adopter region,” she said. “The decision was made by the elected officials in the region. They came to a decision in terms of readiness for the change.”

Most people in Washington will stay enrolled in their current health plan. If that plan will not be an option in 2019 or 2020, the Health Care Authority will auto-enroll Medicaid clients to one of the available plans.