1. Suzanne Fields, MSW Technical Assistance Collaborative Accelerating Reform Initiative Madison, WI February 11, 2010

2. Highlights of Reform Opportunities Wellstone-Domenici Mental Health Parity and Addictions Equity Act Health Care Reform While still early implementation (parity act) or under debate (health care reform), common needs are recognized for reform 2

3. State Level Medicaid Priorities and Pressures Integrating care Improving quality Controlling costs 3

4. Typical Approaches to Medicaid Cost Containment Medicaid Enrollment Services Rates Utilization 4

5. Integration System –level changes Medical homes, integrated care teams, accountable care organizations /health centers Electronic health records, telemedicine, HIT Practice-level changes Using electronic health records and IT Working with primary care / health centers Virtual teams /new roles on teams 5

6. Improving Quality System and practice level changes Measuring an individuals improvement/outcomes Measuring provider performance Measuring client outcomes across a continuum of services Promoting efficiencies 6

7. Managed Care Currently, 70% of Medicaid enrolled individuals are covered under a managed care arrangement Managed care enrollment will rise under HCR Medicaid reliance on managed care, coupled with changes in coverage under private insurers, will result in numerous rules/processes to learn 7

8. Managed Care (cont) Providers and managed care Black hole/mystery box Medicaid agencies and MCO’s will have varying knowledge about SA Establish relationship with MCO 3 important words and what they really mean Learn the rules and processes and teach it to staff 8