Medicaid clients see transition to ‘whole-person care’ on Jan. 1

From the Washington State Health Care Authority

Beginning Jan. 1, Washington Apple Health (Medicaid) clients in the state’s North Central region (Chelan, Douglas, and Grant counties) will transition to a “whole-person” approach to care delivery. Services will be coordinated through a single health plan so that people receive the help they need for body and mind, including mental health and substance use treatment.

“It can be hard for individuals — especially those with multiple complex conditions — to receive the full spectrum of care and services they need,” said Health Care Authority (HCA) State Medicaid Director MaryAnne Lindeblad. “Treating the whole person is a better way to help people get and stay healthy. By combining both sets of benefits under the same managed care plan, the plan will be responsible and accountable for addressing both the medical and behavioral health needs of individuals, leading to more integrated care and better outcomes.”

Apple Health coverage for about 65,000 people in Chelan, Douglas, and Grant counties will be covered by Amerigroup, Coordinated Care, and Molina Healthcare.

In 2014, state legislation directed a transition to fully integrate the purchasing of medical and behavioral health services for Apple Health clients through a managed care system no later than Jan. 1, 2020.

Five other regions in Washington have told the HCA they are ready to make the shift to whole-person care, ahead of the timeline required under state law. Greater Columbia, King, North Sound, Pierce and Spokane regional service areas will make the transition in 2019.

The Southwest Washington region (Clark and Skamania counties) was an early adopter of this integrated care model. Since making the transition on April 1, 2016, the community has since seen several statistically significant changes in care compared to other regions of the state.

“We are working closely with our partners in the North Central region to ensure a smooth transition on Jan. 1 and are ready to respond quickly to the needs of clients, providers and stakeholders in the region,” Lindeblad said.

Editor’s Note: For more information on the Washington Apple Health transition, visit wwrld.us/IntegratedCareFAQ.

The Washington State Health Care Authority purchases health care for more than two million Washington residents through Apple Health (Medicaid) and the Public Employees Benefits Board (PEBB) Program.



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Medicaid clients see transition to ‘whole-person care’ on Jan. 1