GMH/SA Benefit for Acute Duals Integration Update Kijuana Wright March 18, 2015.

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Presentation transcript:

GMH/SA Benefit for Acute Duals Integration Update Kijuana Wright March 18, 2015

General Mental Health and Substance Abuse Population to be Served by Acute Health Plans 2 Reaching across Arizona to provide comprehensive quality health care for those in need Medicare Parts A and/or B AND AHCCCS eligible members aged 18 and older, enrolled in an acute health plan, not SMI and not enrolled in AIHP Total duals population 87,000 estimated

GMH/SA Dual Integration Goals Integration of services – this is enhanced when members are in aligned plans Payment modernization – greater capacity to link incentives Enhance simplicity for members and providers AHCCCS and plans are poised to react to any future changes that CMS imposes on the D-SNP program 3 Reaching across Arizona to provide comprehensive quality health care for those in need

Array of Choices for Native American Members American Indian Health Program (AIHP) Choice to enroll in either a TRBHA or RBHA Acute Health Plan Choice to enroll in either a TRBHA or RBHA Integrated Acute Plan Behavioral health and physical health delivered 4 Reaching across Arizona to provide comprehensive quality health care for those in need American Indian Members can always access services at IHS and tribally owned and/or operated 638 facilities at any time

General Mental Health/Substance Abuse Benefit for Duals Acute plans have submitted implementation plans to AHCCCS on 10/2014 Active internal workgroups (contract/policy changes) AHCCCS has provided a variety of data to acute plans o Top 100 providers o GMH/SA utilization percentage by cost bucket o Education list for plan staff o Format of DEF file 5 Reaching across Arizona to provide comprehensive quality health care for those in need

General Mental Health/Substance Abuse Benefit for Duals AHCCCS has sent out the readiness tool on 2/17/15 to each plan outlining the requirements with due dates. Upcoming due dates- o Staffing assessment due 3/16/15 o Technology assessment due 3/16/15 Plans will meet with AHCCCS and ADHS monthly starting 3/19/15 6 Reaching across Arizona to provide comprehensive quality health care for those in need

General Mental Health/Substance Abuse Benefit for Duals In development: o Communication plan for stakeholders o FAQs list for providers Additional information to be shared with plans on an ongoing basis 7 Reaching across Arizona to provide comprehensive quality health care for those in need

Thank You! 8 Reaching across Arizona to provide comprehensive quality health care for those in need