We recently attended the Medicaid Managed Care Congress held May 20-22 in Baltimore, Maryland. Social determinants, behavioral health integration and costs associated with long-term services and supports (LTSS) were heavy on the minds of Medicaid directors and others working to support Medicaid beneficiaries.
Stephanie Bates on Helping Vulnerable Populations
Stephanie Bates, deputy commissioner for the Kentucky Department for Medicaid Services, explained during a panel that Kentucky is hyper-focused on its foster care transformation program, which has the goal of greater coordination of health and community services for this vulnerable population so that they can return home with their families. The state is taking some unique approaches that, if successful, could make its program a blueprint for others across the country. It’s also pushing a program to better coordinate care for its homeless population to ensure they don’t slip through the cracks.
Jon Hamdorf on Better Collaborating on Behavioral and Mental Health
Jon Hamdorf, director at Navigant and former Kansas Medicaid director, delivered an insightful presentation on the fundamentals of behavioral health integration. He cited a study involving Maryland Medicaid Primary Care and its integration with opioid use disorder (OUD) services which found that the integrated program was more effective than substance use disorder (SUD)-only treatment in a number of outcomes, including lowering hospital stays and increasing buprenorphine treatment retention rates (79 percent as compared to 61 percent).
Hamdorf noted that while we’re farther away as an industry from truly integrated behavioral and mental health with physician . health—we can certainly work to better coordinate for the good of the patient. The better care can be coordinated, the better the outcome for patients with behavioral and mental health concerns.
Dr. Jamo Rubin on Addressing Social Determinants of Health
Dr. Jamo Rubin, founder of TAVHealth, spoke during a vibrant session he dubbed “Jurassic Privacy Park.” He discussed coordination around social determinants and, through the lens of patient privacy, how and if we should be collecting and sharing some patient information related to social determinants of health (SDOH). During his session Dr. Rubin noted spoke passionately about why we “can’t just solve one social determinant issue, we have to identify and solve them all.” An example he cited was for a health plan to consider why a pregnant woman might not take her pre-paid Uber or Lyft ride to her prenatal appointment. Dr. Rubin pointed out that, while the patient may have now had access to transportation, her care coordinators neglected to consider her full story—that she lives at home with her mother who is on dialysis and frail, and she has two other young children for whom she didn’t have childcare. Of course she didn’t take the car to her prenatal appointment. Dr. Rubin closed his presentation with another example of how we can collectively work together for better outcomes: “Pay for this man’s utility bill, so his refrigerator comes on and his insulin doesn’t go bad.”
Finding Innovative Solutions for D-SNPs
We also sat in on several discussions around best practices for Dual Eligible Special Needs Programs, or D-SNPs. There’s currently a lot of experimentation by states to see what works—but unfortunately there’s no secret sauce to best serving these beneficiaries under D-SNPs, though many states are making big strides and working on a number of innovative solutions.
Dr. Deborah Jean Parsons on Supporting Behavioral Health Members
Dr. Deborah Jean Parsons, director of integrated health at Aspire Health Alliance, spoke about the importance of behavioral health integration and the role technology plays as part of a Medicaid accountable care organization (ACO) program delivered by MassHealth. Aspire Health Alliance in Quincy, Massachusetts, drives the South Shore Community Partnership which cares for MassHealth beneficiaries, many of whom don’t have accurate contact information–making it difficult to provide support to these members.
To drive value, however, Dr. Parsons detailed how her team has implemented Collective Medical’s care collaboration platform, which is connected to most hospitals in Massachusetts, other behavioral health clinics, Federally Qualified Health Centers (FQHCs) and skilled nursing facilities (SNFs), to be alerted in real time when a member registers in a nearby emergency department. When this happens, care managers can quickly reach the patient and address his or her needs. This technology-enabled approach has helped Aspire increase enrollments in the opt-in program by about 150 percent.
We enjoyed meeting everyone and are looking forward to next year!
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