HCA announces managed care plans offering integrated care starting in 2019 and 2020
As Washington moves toward integrating physical and behavioral health statewide for Apple Health (Medicaid) clients by 2020, HCA has announced final decisions about which managed care plans will offer coverage in different regions of the state beginning in 2019 and 2020.
These decisions were made after a competitive bidding process available to the five existing Apple Health managed care plans.
Under integrated managed care, services are coordinated through a single health plan so that people receive the help they need for body and mind, including mental health and substance use disorder treatment.
- Five regions will move to integrated managed care in January 2019: Greater Columbia, King, North Sound, Pierce and Spokane regional service areas.
- The remaining areas will move to integrated managed care in January 2020: Great Rivers, Salish, and Thurston-Mason.
- Southwest Washington region (Clark and Skamania counties) was the first to move to integrated care, in April 2016. The North Central region (Chelan, Douglas and Grant counties) integrated in January 2018. Since making the transition Southwest Washington has since seen several statistically significant changes in care compared to other regions of the state.
All decisions are contingent upon completion of readiness review of the managed care plans and final contract signing.
Why are we moving to integrated managed care?
In 2014, state legislation directed a transition to fully integrate the purchasing of medical and behavioral health services for Apple Health clients through a managed care system no later than January 1, 2020. This is part of HCA’s ongoing efforts to transform the way we purchase health care to ensure high-quality care at the best price.
Before care was integrated, Apple Health clients with co-occurring disorders had to navigate three separate systems in order to access the physical and behavioral health services needed to stay healthy. The physical health, mental health, and substance use disorder delivery systems often didn’t communicate about clients’ care, which led to duplication of services, poorly coordinated care, lower health outcomes, and a frustrating experience for our states’ Apple Health clients and the providers who serve them.