Integrated Benefits for Medicaid Enrollees Lead to Better Behavioral Health Outcomes and Lower Costs

ALBANY, NY (02/15/2011)(readMedia)-- Representatives of New York's top public health plans will be in Albany Tuesday, February 15 to discuss strategies to deliver high quality care at lower cost through the State's Medicaid program. Members of the Coalition of New York State Public Health Plans are discussing new evidence that the State can deliver better, more cost-effective care by integrating behavioral health care services into the benefit package for Medicaid managed care enrollees.

Coalition plans are sharing new data released by the New York State Department of Health which shows that when health plans manage an integrated benefit, including physical and behavioral health care services, they are able to deliver higher quality, more cost-effective care. The analysis indicates that Medicaid enrollees with integrated physical and behavioral health benefits have:

• Fewer behavioral health admissions.
• Significantly lower behavioral health inpatient costs.
• Shorter behavioral health inpatient stays.
• Better quality of care.

The data clearly supports State proposals that New York utilize its managed care network to extend behavioral health coverage to all Medicaid managed care enrollees. New York's public health plans have successfully managed behavioral health benefits for the vast majority of their members – but these benefits have been "carved out" for certain enrollees. With new evidence that members with integrated behavioral health benefits have better utilization, outcomes and cost experience, the State should give public health plans responsibility for managing these services for all enrollees.

Members of the Coalition of New York State Public Health Plans have demonstrated outstanding outcomes in the delivery of mental health services and many other state and national quality care measures including childhood immunization, breast cancer screening and member satisfaction. Coalition plans exceeded national Medicaid standards on 74% of quality care measures using innovative approaches to care management.

Public health plans provide uninsured New Yorkers with one-on-one assistance to navigate eligibility requirements to enroll in Medicaid and Family Health Plus programs. Specially trained facilitated enrollers help 26,000 uninsured individuals every month complete applications in New York City alone. Facilitated enrollment helps keep consumers enrolled in managed care plans, maintaining access to primary and preventive care and reducing the need for expensive emergency room care. This results in better care for individuals and overall cost savings. A proposal to the Medicaid Redesign Team suggests that funding for this critical public coverage infrastructure be eliminated. Without facilitated enrollment, individuals will remain uninsured and seek care in hospital emergency rooms or community health centers, straining these providers' scarce resources with uncompensated care costs.

The Coalition of New York State Public Health Plans provides high quality health care to more than 2.5 million children and adults using comprehensive networks of providers and services that work together to ensure a coordinated continuum of care. Medicaid reform provides opportunities to cover uninsured New Yorkers while cutting costs by promoting care management.

Detailed analysis of New York State Department of Health data on behavioral health care and managed care is available on the Coalition of New York State Public Health Plan's website at www.phpcoalition.org in two documents: Medicaid Managed Care Works for New York and Medicaid Managed Care and Behavioral Health.

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Members of the Coalition of New York State Public Health Plans offer decades of experience in delivering high quality services to populations that often experience significant barriers to health care. Coalition plans are sponsored by or affiliated with public and not-for-profit hospitals, community health centers and physicians. Coalition members include:

Affinity Health Plan (New York City and Nassau, Orange, Suffolk, Rockland and Westchester Counties)

Fidelis Care New York (New York City and 41 counties)

Healthfirst (New York City and Nassau and Suffolk Counties)

Health Plus (New York City and Nassau County)

Hudson Health Plan (Dutchess, Orange, Rockland, Sullivan, Ulster and Westchester Counties)

MetroPlus Health Plan (Bronx, Kings, New York and Queens Counties)

Monroe Plan for Medical Care (Broome, Chemung, Chenango, Livingston, Monroe, Ontario, Orleans, Schuyler, Seneca, Steuben, Tioga, Wayne and Yates Counties)

Neighborhood Health Providers (New York City and Suffolk County)

Total Care (Cortland, Onondaga, Oswego and Tompkins Counties)