Tuesday, October 25, 2011

Coordinated Care Developments

CMS launched an initiative to help people with chronic mental illnesses, substance abuse disorders, and other chronic conditions receive a new level of coordinated healthcare. The Affordable Care Act now provides new flexibility and resources for State Medicaid programs to provide new health home services for people with chronic conditions.

Using new tools and resources, Missouri will be the first state to create the health home model that will go into effect January 1, 2012. As a health home, Missouri’s community mental health centers will serve as the central source of care for patients with mental health issues and will coordinate all medical needs including primary, acute, behavioral health, and long term services and support for persons with chronic illnesses.

States with approved proposals will receive enhanced 90 percent federal matching funds to support this initiative for two years. The state has worked closely with both CMS and SAMHSA in developing the health home model. Currently, two other states such as Rhode Island and Oregon have applied for a similar Health Home State Plan Amendment

Two other CMS initiatives were launched to include the Medicare Shared Savings Program and the Advance Payment Model to help providers from ACOs. The Medicare Shared Saving Program will provide incentives for participating healthcare providers who agree to work together and become accountable for coordinating care for patients.

Providers, who band together through this model and meet certain quality standards based upon, patient outcomes and care coordination among the provider team, may share in savings they achieve for the Medicare program.

The Advance Payment Model will provide additional support to physician-owned and rural providers participating in the Medicare Shared Savings Program so they would also benefit from additional start-up resources to build the necessary infrastructure, such as new staff or IT systems. The advanced payments would be recovered from any future shared savings achieved by the ACO.