Health Care

MDHHS initiative looks to overhaul health services

Muskegon County Community Mental Health and West Michigan Community Mental Health to conduct joint pilot.

March 30, 2018
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The Michigan Department of Health and Human Services is working to improve coordination between physical and behavioral health services in the state.

Three pilot sites have been chosen for the Medicaid Health Plan Pilot initiative meant to see if the changes can lead to expanding care with financial efficiency.

Muskegon County Community Mental Health (HealthWest) and West Michigan Community Mental Health will conduct a joint pilot. The other two sites chosen were Genesee Health System and Saginaw County Community Mental Health Authority.

This initiative is based on Section 298 in the Public Act 268 of 2016, which the Michigan legislature revised last year.

MDHHS has been working since August to develop the structure of the pilots to test the integration of Medicaid-funded physical health and behavioral health services.

This pilot changes the structure for how community mental health systems are funded in Michigan.

In the current model, Medicaid funding for CMH services is managed separately from Medicaid funding for physical health services.

“It makes it difficult to coordinate care for individuals with co-occurring needs,” said Phil Kurdunowicz, policy analyst for MDHHS.

Under the pilot, the funding for both services will flow through the same entities.

This change in funding flow means the pilot sites will contract directly with the region’s Medicaid health plans as a behavioral health care provider and network manager.

One of the requirements of the pilot is any physical health care cost savings resulting from the project must be applied to mental health care costs.

This allows HealthWest and West Michigan CMH to continue providing core services but would additionally expand access to critical services, such as care coordination for those with a broader spectrum of behavioral and physical health needs.

The goal is for more affordable, better overall care.

“People get healthy and stay healthy longer when we treat the entire person versus treating only part of their condition,” said Lisa Williams, executive director at West Michigan CMH.

Many organizations already integrate care, according to Julia Rupp, HealthWest executive director, but the next step is integrating funding.

She said HealthWest data shows integrated care creates a reduction in hospitalization and emergency room use, as well as improved health outcomes.

This is a “snapshot” of national trends, Williams said.

She said there has been a movement at the federal level for about seven years to financially integrate care.

She added the initial driver was to figure out how to get a handle on exponentially growing health care costs.

“They really started to look at what are ways we can align the health care system to support better outcomes at lower costs,” Williams said.

The pilot will last at least two years and includes an evaluation by a research team from the University of Michigan to determine whether this system works.

The pilot sites were chosen through a request for information that was due Feb. 20.

Minimum requirements included applicants be community mental health service providers, support from at least half of the Medicaid health plans within the proposed pilot region and a plan demonstrating full financial integration.

The department used input from representatives of the current system to develop a white paper that describes the parameters for the pilots.

Contracts for implementation of the pilots will be between MDHHS and the MHPs operating in the pilot regions. In the coming months, MDHHS will work with the selected organizations to finalize the structure of the pilots, with plans for pilot implementation by Oct. 1.

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