Behavioral Health Integration
In Arizona, behavioral health has historically been a carved out benefit which has been separately managed by Regional Behavioral Health Authorities (RBHAs). Because of this structure, up to four different health care systems might be necessary for an individual with a serious mental illness (SMI) to obtain health care: the AHCCCS acute health plan for physical health services; the RBHA for behavioral health services; Medicare for, persons with SMI who are dually eligible for both Medicaid and Medicare; and Medicare Part D for medications.
Navigating the complex health care system is one of the greatest barriers to obtaining medically necessary health care. For Arizonans with SMI, obtaining needed health care has been challenging and further complicated by concerns around poor medication management and stigma, sometimes causing many individuals to forgo physical health care. Because many persons with SMI also experience co-morbidities, management of chronic diseases like diabetes or hypertension has also been poor.
To help address these issues, AHCCCS collaborated with behavioral health partners to create a more streamlined system that reduces barriers to care for members and also increases accountability of the RBHA for managing the “whole health” of persons with SMI. To carry out this new approach, RBHAs manage the delivery of physical health services, in addition to behavioral health services, to increase member engagement in obtaining medically necessary physical health services.
On April 1, 2014, approximately 17,000 members with Serious Mental Illness in Maricopa County were transitioned to a single plan, Mercy Maricopa Integrated Care, to manage both their behavioral and physical health care needs. On October 1, 2015, this model will be launched statewide through contracts with Health Choice Integrated Care in Northern Arizona and Cenpatico Integrated Care in Southern Arizona. For more information please see the resource links below.
Greater Arizona Integration
To enhance care coordination and broaden accessibility of health care through AHCCCS, members determined to have a serious mental illness (SMI) who do not reside in Maricopa County will be enrolled in one health plan beginning October 1, 2015 for both their physical and behavioral health care needs. These members will be reassigned to one of the integrated health plans (Regional Behavioral Health Authorities (RBHAs) listed below, depending on where they live. Letters have been sent to those members whose enrollment will change to one of the integrated health plans to inform them of their new enrollment.
Members residing in the following Counties will be receiving physical and behavioral health services from Cenpatico Integrated Care beginning October 1, 2015: Cochise, Greenlee, La Paz, Pima, Pinal, Yuma, Santa Cruz, Graham and zip codes 85542 and 85192.
Members residing in the following Counties will be receiving physical and behavioral health services from Health Choice Integrated Care beginning October 1, 2015: Apache, Coconino, Mohave, Navaho, Yavapai and Gila (except zip codes 85542 and 85192).