Tags Posts tagged with "Physical Health Managed Care Organizations"

Physical Health Managed Care Organizations

During the past few years, the state Medicaid program, HealthChoices, has begun to implement and expand the use of Value-Based Purchasing models in procurement contracts with all Physical Health Managed Care Organizations (PH-MCOs). With a goal of increasing clinical outcomes, patient satisfaction, and cost management, the PH-MCOs have called for increased use of such Value-Based Purchasing models as Pay for Performance, Patient Centered Medical Homes, and Bundled Payments. On May 25, the leadership of the Offices of Medical Assistance Programs (OMAP) and Mental Health and Substance Abuse Services (OMHSAS) conducted a webcast to review the implementation process used in HealthChoices by the PH-MCOs and their provider networks, and to introduce the process of expanding Value-Based Purchasing to the Behavioral Health Managed Care Organizations and their provider networks. The OMHSAS target for introducing this expansion is January, 2018 with a focus on integrated and collaborative behavioral and physical health and care coordination.

The Physical Health Managed Care Organizations (PH-MCOs) serving Pennsylvania’s HealthChoices Medicaid program are now inviting psychiatric service providers to submit a response for the Telephonic Psychiatric Service (TiPS) Request for Proposals (RFP). The PH-MCOs will contract for TiPS that will provide real time telephonic consultative services to primary care providers (PCPs), and other prescribers of psychotropic medications, for children under the age of 21. A TiPS provider is responsible for establishing and maintaining a team of behavioral health professionals who will be available to respond to inquiries from PCPs seeking assistance in providing pediatric behavioral health care. Qualified applicants must have a TiPS staff which includes one full-time equivalent child psychiatrist, one full-time equivalent behavioral health therapist, and one full-time equivalent care coordinator. Now available are the RFP, and supplemental information, including pediatric membership by plan/zone, and a 2014 Health Affairs article on a similar program in Massachusetts. A vendor fair for interested respondents is being held on Tuesday, January 26 in Mechanicsburg. See the RFP for additional details. All questions should be directed to MCO Coalition Consultant, Emily Katz.