MDHHS to run pilots to test Medicaid mental and behavioral health integration

Government organizations always work to ensure good health of citizens by making the best mental and physical health services available to them. In an attempt to ensure the same, the Michigan Department of Health and Human Services (MDHHS) has decided to implement pilot projects to test the efficiency of integrating physical and behavioral health delivery systems for Medicaid patients in its 2018 budget. The budget allocation has been finalized in consultation with the House, Senate and Gov. Rick Snyder.

MDHHS wants to be doubly sure before it finally integrates the two and, thus, has planned to undertake four pilot studies in the next three years. Planned to be supervised by a skilled project facilitator who will be hired by the MDHHS, the pilots will analyze whether the combined system would be able to expand the services and lower the costs for Medicaid patients.

As per the planned budget, the MDHHS is to submit a report by Nov. 1, outlining the pilots, their implementation periods, and the expected obstacles with their solutions. While two of the pilots are expected to start this year, the other two should start no later than March 1 and the time frame for each pilot would be at least two years.

A budget of $2.8 million in fiscal 2017 (to plan the pilots) and $3.1 million for fiscal 2018 (to execute the pilots), that begins on Oct. 1, 2017, has been earmarked. General state tax funds would contribute $2 million to the total amount.

Mental health and Medicaid HMO association’s discrepancy

Mental health advocates and providers are not in favor of Medicaid Health Management Organizations (HMO) associations executing and controlling the pilot. They feel that the HMOs lack experience in handling such projects and that their profit-making mentalities would hamper public good.

This disagreement has been prevalent since January 2016, when Gov. Snyder proposed a provision that would allow the state HMOs to manage the $2.6 billion Medicaid behavioral health system, in addition to the approximately $9 billion physical health system that it was already managing. This provision was to be included in the 2017 state budget.

At present, there are a total of 10 prepaid inpatient health plans (PIHPs) that are operated by the public mental health system and are responsible for managing the funding and contracting with the different providers.

Performance metrics by MDHHS

This plan of integrating the health services is strongly supported by Senator Mike Shirkey. He said that his only aim to push for the pilots was to see reduced administration costs, no duplicity and low wastage. He further said that any savings from the implementation of the pilot will be reinvested into expanding the health plan so that more funds are available to be spent per person on physical and behavioral health.

In order to assess the performance of the integrated physical and mental health plans, certain performance metrics were developed by the MDHHS. These were:

  • Better coordination between the stakeholders of physical and behavioral health.
  • Improved accessibility and availability of services to individuals with substance use disorder (SUD), developmental or intellectual disabilities and mental health disorders.
  • Advantages and allowances that come with full access to community-based supports and services.
  • Level of customer satisfaction
  • Status of customer health
  • Stability of the provider
  • Before and after treatment and service comparison for the pilots
  • Demonstration models
  • Level and number of best practices employed
  • Efficient use of finances
  • Any other applicable parameter

Seeking help

As per the MDHHS estimates, there are approximately 350,000 people who are either suffering from mental illnesses, developmental and intellectual disabilities, and/or substance abuse problems in the state’s Medicaid program. It, therefore, becomes vital to bring in certain amendments that can ease the availability of help to them.

If an individual experiences any symptoms of mental illness, it is important for him/her to seek help immediately. Ignoring these symptoms can complicate the issue and deteriorate the condition. It is also important for the federal bodies to ensure that help is available to all dealing with mental illnesses.

If you or someone you know is dealing with any form of mental illness and is looking forward to consult a mental health specialist, the 24/7 Mental Health Helpline can help. Call us at our 24/7 helpline number 855-653-8178 or chat online with our mental health professional who can connect you with the most comprehensive mental health rehabilitation centers in your vicinity.