Newsletter December 2023
Organizational Updates
Amanda Ittner, MBA
Deputy Director
Medicaid Health Plan Rebid
On October 30, the Michigan Department of Health and Human Services (MDHHS) announced the procurement
(rebid) for the Comprehensive Health Care Program contract for Michigan’s Medicaid Health Plans (MHP). The
rebid includes initiatives identified by many stakeholders that informed the five MIHealthyLife strategic pillars:
- Serve the Whole Person, Coordinating Health and Health Related Needs
- Give All Kids a Healthy Start
- Promote Health Equity and Reduce Racial and Ethnic Disparities
- Drive Innovation and Operational Excellence
- Engage Members, Families and Communities
Responses from bidders are due on January 16, 2024, with expected Medicaid Health Plan contracts effective on
October 1, 2024.
MHP Coordination with the Public Behavioral Health System
MSHN currently works with eight (8) MHPs, which could change after MDHHS announces the selection next
year. The PIHP contract with MDHHS includes many elements to address coordination with the Medicaid Health
Plans in the region and includes requirements to:
- Have written functioning Coordination agreements with each Medicaid Health Plan in MSHN’s service area
that must address the integration of physical and mental health services. - Include the participating health plans in the regional consumer handbook.
- Work with the state to develop initiatives to better integrate services and provide incentives to support
behavioral health integration. - Implement practices to encourage all consumers eligible for specialty mental health services to receive a
physical health assessment including identification of the primary health care home/provider, medication
history, identification of current and past physical health care and referrals for appropriate services. - Adhere to improvement and benchmarks for joint metrics that account for 30% of the withhold (.75% of
revenue).
During FY 2023, MSHN had integrated care plans for 50 individuals in partnership with the 8 Medicaid Health
Plans in-region (Blue Cross Complete, Meridian Health Plan, Molina, United Health Care, Aetna, Priority Health,
HAP Empowered, and McLaren). 75% of individuals experienced a reduction in Emergency Department (ED)
utilization as compared to the 12-month period prior to being opened for care coordination.
Anticipated Changes in the Public Behavioral Health System identified in the Rebid
While the public behavioral health system responsibility for the specialty behavioral health system is not
significantly affected by the rebid, there are some changes as noted below:
- Clarification regarding the MHP obligation to pay for crisis intervention services in Emergency Departments
for persons with Severe Mental Illness not associated with the PIHP. - Continuation of Joint Care Management with PIHPs but additional focus on children in foster care.
- Stronger coordination requirements for children in foster care, including connections between care
managers, health liaisons, foster care workers, MDHHS, and PIHP/CMH providers. - Additional focus on addressing social determinants of health.
MSHN as well as our CMHSP partners continue our efforts on improving care coordination for individuals served
that includes stronger collaboration with the MHP’s. We anticipate the results of the rebid will strengthen those
partnerships and support efforts included in the MSHN strategic plan, including focus on access, children services,
health equity and social determinants of health.
For further information or questions, please contact Amanda @ Amanda.Ittner@midstatehealthnetwork.org.