Beacon to be behavioral health subcontractor to two Massachusetts health plans
Woburn, MA, Nov. 26, 2012 - Beacon Health Strategies' long-standing successful experience in treating individuals with complex behavioral and medical illnesses has been recognized through its role in successful proposals submitted by its health plan partners, Boston Medical Center HealthNet Plan (BMCHP) and Neighborhood Health Plan (NHP) of Massachusetts, to participate in the Duals Demonstration, a joint initiative of the Centers for Medicare and Medicaid Services (CMS) and Massachusetts' Executive Office of Health and Human Services (EOHHS).
With Beacon as behavioral health subcontractor, BMCHP and NHP are advancing to a joint state and federal readiness review process to prepare to serve as Integrated Care Organizations (ICOs). ICOs will provide integrated care for those individuals age 21-64 who are "dually eligible" for both Medicare and Medicaid benefits. The three-year Demonstration to integrate Care for Dual Eligible Individuals aims to integrate medical and behavioral health care and long-term services and supports to improve health outcomes at reduced cost.
The target population for the Demonstration includes adults with a range of physical disabilities, intellectual and developmental disabilities, behavioral health needs, and chronic conditions. ICOs will be responsible for providing care management services to better coordinate and integrate healthcare services received by their enrollees. These care management services will emphasize avoiding unnecessary inpatient admissions and use of emergency rooms through increased member engagement, community-based services and better communication among a member's providers. The project's payment structure aligns incentives between Medicare and Medicaid through a blended global financial arrangement that promotes integrated, person-centered care and avoids past practices of poorly aligned financial incentives influencing care planning. Coverage is expected to start April 1, 2013.
"Beacon and its partners, Boston Medical Center HealthNet Plan and Neighborhood Health Plan, have a long and successful history of helping individuals and their families dealing with both serious physical and behavioral illnesses navigate a disjointed healthcare system to achieve better care planning and health outcomes," said Beacon's CEO Timothy Murphy.
"Indeed, Beacon's 16 years of experience in Massachusetts and across the nation has taught us that the only kind of care is holistic care; if we don't treat the whole person - including their social, physical and behavioral needs - we will likely fail in our mutual goals of improving the person's health status and making sure that every dollar expended in health benefits the person and society. Beacon is looking forward to helping our partners, as well as CMS and EOHHS, show that this approach to care works."
Beacon's participation in this Duals Demonstration project adds to its recent duals demonstration awards in California, where Beacon is expected to serve nearly 50,000 duals members beginning in the summer of 2013. "As the need to control costs and improve health outcomes drives Medicare and Medicaid to find solutions to the better delievery of care, we are excited to play our role to bring better services and value in treating dually eligible individuals," added Murphy.
About Beacon Health Strategies
Founded in 1996, Beacon Health Strategies is a leader in behavioral health care management services for Medicaid, Medicare and commercial populations with a presence in 15 states. Accredited by both URAC and NCQA, Beacon's success derives from its member-centric and locally administered managed care services, active integration of members' medical and behavioral health care needs, innovative clinical programming, and customized solutions for every health plan partner.
About Boston Medical Center HealthNet Plan
BMCHP is a not-for-profit managed care organization serving more than 260,000 members across Massachusetts through three product lines: MassHealth, Commonwealth Care, and commercial (Employer Choice / Commonwealth Choice). It is the largest MassHealth managed care organization in Massachusetts. BMCHP was recognized for its ongoing commitment to quality when it was named one of the top ten Medicaid health plans in the country according to the National Committee for Quality Assurance (NCQA) Medicaid Health Insurance Plan Ranking 2012-2013. In addition, it has maintained Excellent Accreditation from NCQA for its Massachusetts Medicaid plan since its initial acreditation in 2009.
About Neighborhood Health Plan
NHP, a Massachusetts-based not-for-profit corporation, has provided comprehansive health services since 1986. An NCQA-accredited managed care organization, NHP serves MassHealth, Commonwealth Care, Commonwealth Choice, and fully insured commercial members across the Commonwealth. By working closely with the MassHealth program and commercial purchasers, and by partnering with community health centers and other providers, NHP grew rapidly from a few thousand members in the late 1980s to approximately 250,000 members today throughout Massachusetts.