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Blog: 1 Year into Integrated Managed Care

One Year Into Integrated Managed Care

At the beginning of 2020, the CPAA region went through a transition known as Integrated Managed Care (IMC), which changed the way behavioral health services were paid for across the state. Traditionally, behavioral health services were reimbursed by Behavioral Health Organizations (BHOs) but that reimbursement has shifted to Managed Care Organizations (MCOs) resulting in both medical and behavioral health services being reimbursed by MCOs.

The CPAA region is one year into IMC, and the transition has been relatively smooth for behavioral health agencies. Throughout 2020, agencies have been focused on fine tuning new electronic health records, configuring new data collection methods in order to meet state requirements, and ensuring proper coding and billing practices are in place to maximize funding. One important element that made this transition successful is the strength of partnerships in the CPAA region between different behavioral health agencies, MCOs, and the Health Care Authority. Without strong partnerships, the transition would have been much more difficult. These cross-agency partnerships continue to be fostered through numerous workgroups, committees, and regional initiatives.

Looking forward, MCOs and behavioral health agencies will be increasingly interested in how to develop effective value-based contracts (VBCs) for behavioral health. As these types of contracts require historical data, these contracts likely won’t be rolled out for a few years yet. However, this is a top priority going forward as Washington State continues to move towards paying for value-based care. Due to the successful IMC transition and reliable partnerships throughout the region, behavioral health agencies and MCOs should be prepared, confident, and ready to take the next step towards paying for value.