NJAMHAA Partners with
Health Maintenance Organizations and many Others to Support Member Providers
In 2011, NJAMHAA created the Health Maintenance Organization
(HMO) Council to ensure a robust network of providers and continuity of
medically necessary care for beneficiaries with chronic conditions. Throughout
this time, the HMO Council has been a dynamic group consisting of HMOs, NJAMHAA
member providers and representatives from the Division of Medical Assistance
and Health Services and the
Division of Mental Health and Addiction Services. We engage in
productive discussions about timely issues that involve HMOs and affect
providers and access to their services.
The current hot topic that the HMO Council, as well as other
groups that NJAMHAA facilitates, is focusing on is the upcoming changes to HMOs’ coverage of behavioral health
services: Beginning July 1, 2018, HMOs will cover acute, hospital-based mental
health services for all Medicaid beneficiaries and substance use services for
individuals who are receiving Managed Long Term Services and Supports, people
with intellectual/developmental disabilities and individuals who are covered by
the Full Integrated Dually Eligible Special Needs Plan.
The inevitable
change from fee-for-service reimbursement to value-based payments that is coming
is another important topic that the HMO Council has been discussing and will
continue to address. Presentations during meetings, as well as dedicated
training outside of these meetings, are helping providers prepare for this
major change, and more training will be developed as needed.
There is certainly a learning curve involved with any change
and NJAMHAA understands it can be overwhelming, especially with multiple major
changes being planned and implemented simultaneously. NJAMHAA aims to help
minimize the stress associated with these changes by arranging for experts to
provide valuable information and guidance. Stay tuned for learning
opportunities through our website (www.njamhaa.org/events) and social media.
We have open lines of communication with many individuals at
HMOs, the state and many other organizations. People with expertise in various
areas that are important to our members work with us to provide what is needed
to help ensure our members’ success.
NJAMHAA is your partner and through our collaboration with the
HMOs, the state and experts in the field, you can develop an extremely strong network!
Stay informed about all that NJAMHAA offers and share opportunities with your
coworkers!
No comments:
Post a Comment