New Practice Models Focus on Integration
November 21, 2013 07:28 PM
MaMHCA recently met with both MBHP and BCBSMA to discuss new practice models based on the integration of physical health and behavioral health. LMHCs are strongly encouraged to develop referral and contractual arrangements with Primary Care Practice (PCP) groups.
o Mass Behavioral Health Partnership (MBHP) is following the Masshealth initiative to “transform and integrate primary care and behavioral health.” They are introducing alternative payment methods: Primary Care Bundled Payments, with a Care Management Allocation and 3 options for including Behavioral Health Services in the Bundle.
o Primary Care Clinicians that participate must provide, either internally, or through contractual agreements, both primary care services and behavioral health services in an integrated model of care delivery in one of three tiers of care. To read more go to Members Only…….. Not a member, joint now
o Blue Cross and Blue Shield of MA, has taken the approach of supporting collaboration by creating “Alternative Quality Contracts” with primary care practices (PCPs) on their panels. These PCP groups are encouraged to have relationships with behavioral health clinicians, either by including them on-site within the practice, or through sub-contracts.
PCP groups with “Alternative Quality Contracts” will have to achieve positive scores on 64 performance measures, including a measure(s) for behavioral health. Screening and referrals for Depression are among the measures, and timeliness of referrals.
PCPs will be looking for reliable, available local/ accessible referrals. It will be up to the behavioral health clinicians (LMHCs and other MA level folk) to demonstrate how they can add value to the PCP practice.
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