The funding for Medicaid behavioral health and primary care services have been integrated through recent expansions of managed care. However, behavioral health and primary care services have not been integrated. SB 58 (83rd) directed HHSC to integrate behavioral health rehabilitative and case management services into managed care. It was the impetus for the newly designed managed care delivery of mental health rehabilitative services and, to date, has only been partially implemented. The legislation required the creation of the Behavioral Health Integration Advisory Committee.
The phase one recommendations of the advisory committee fall into the areas outlined below. The report with the full recommendations can be found at http://www.hhsc.state.tx.us/about_hhsc/AdvisoryCommittees/bhiac-docs/Phase-I-Recommendation.pdf.
The foundation supports implementation of the recommendations generated from this committee as essential to moving to a truly integrated health care system.
Recommendations:
- Holistic Treatment: Holistic care is an approach to health and wellness that includes treatment for all conditions in a coordinated fashion. Integrating mental health, substance abuse, and primary care services produces the best outcomes and is the most effective approach to caring for people with multiple healthcare needs.
- Patient Activation: Patients play a vital role in their health and wellness and must have the knowledge, skills, and confidence to manage their health. The Medicaid system plays an important role in providing opportunities for patients to become active participants in their health care.
- Access: Individuals must have access to a continuum of quality health care to improve health outcomes.
- Administrative Simplification: In a multi-payer managed care system, efforts must be made to simplify the administrative burden for providers in order to maximize their efficiency and time with patients.
- State Oversight: The Health and Human Services Commission plays an important role in oversight of the managed care system. State actions should encourage an efficient and effective system.