Thousands of Oklahoma adults and children with serious mental illnesses will have more integrated Medicaid services, starting in January.
The Oklahoma Health Care Authority board voted Wednesday to approve new rates to pay medical professionals to provide care in a “health home” model.
The Affordable Care Act created an optional Medicaid plan benefit for states to establish health homes to coordinate care for people with Medicaid who have chronic conditions, according to the Centers for Medicare and Medicaid Services.
Oklahoma leaders chose to create a health home model for adults and children with serious and persistent mental health conditions.
Health home providers are expected to integrate and coordinate all primary, acute, behavioral health, long-term services and supports to treat the “whole person,” according to CMS.
“It’s essentially a health care delivery model that focuses on integrated care, so integrating the primary health care needs along with any mental health needs in one place,” said Traylor Rains, director of policy and planning at the Oklahoma Department of Mental Health and Substance Abuse Services.
Health home providers will be reimbursed at rates ranging from $53.98 per member per month for outreach and engagement services to a $1,009.60 reimbursement rate for wraparound services provided to children with serious emotional disturbances.
For the first two years, the program will be paid for largely through federal money.
The federal government will provide a 90 percent Federal Medical Assistance Percentage rate, which is the federal share of the cost of Medicaid services in each state, according to the Kaiser Family Foundation. This money cannot be used to pay for underlying Medicaid services that are provided outside the health home model.