Monday, June 26, 2017 • 5:30 p.m. – 7:30 p.m.
Optimally Coordinating Care within Behavioral Health for Persons with Serious Mental Illness
Effectively serving persons with Serious Mental Illness (SMI) has been a vexing challenge as states increasingly rely on capitated MCOs. The SMI population is often carved out of a capitated program, or is often included in an MCO’s capitation but with the MCO then carving out its behavioral health care. The presenters will discuss models under consideration within a case study on a state’s Medicaid reform efforts, including a potential model that would enable persons with SMI to enroll in a health plan specifically designed for this subgroup, which would manage highly-integrated, “whole-person-focused” care. The workshop will include:
• A case study on a state’s policymaking landscape and history
• Data analytics that assess the appropriateness of different models
• A description of the SMI-tailored health plan model
ABOUT THE WORKSHOP LEADERS:
Joel Menges, MPA is the Chief Executive Officer of The Menges Group. Mr. Menges’ career focus is on coordinated care programs for high-need populations. He has led hundreds of consulting engagements that involve the design, development, improvement or evaluation of coordinated care programs, including Medicaid initiatives in more than 30 states. Mr. Menges has worked extensively for Medicaid agencies and other state clients, for health plans, and for several trade associations. He has played a significant role in the design of many states’ coordinated care programs and has assisted many health plans in developing new lines of business, entering new states and maintaining their presence in existing markets.
Mr. Menges has also served as lead author of a wide array of policy papers that have shaped and expanded the role of coordinated care for high-need populations. Mr. Menges has a strong and compassionate commitment to improving health status and quality of life for high-need populations, to using taxpayer funds as efficiently as possible, and to replacing traditional fee-for-service coverage models as well as ineffective coordinated care programs with highly effective coordinated care approaches.
Brian Perkins is the Government Relations & Strategic Advisor at Alliance Behavioral Healthcare. Alliance Behavioral Health is the Managed Care Organization (MCO) for public behavioral healthcare for the citizens of Durham, Wake, Cumberland and Johnston counties in North Carolina. Alliance is responsible for providing system management and oversight of public mental health, intellectual/ developmental disability and substance abuse services for approximately 471,000 Medicaid-covered and uninsured North Carolinians within a total population of over 1.8 million. Its vision is to be a leader in North Carolina in transforming the delivery of whole person care in the public sector. This vision guides Alliance in its mission to improve the health and well-being of the people they serve by ensuring highly effective, community-based support and care. Further shaping this vision are core organizational values of accountability and integrity, collaboration, compassion, dignity and respect, and innovation. Alliance manages a diverse network of over 2,500 private service providers and more than 400 professional staff.
Prior to working with Alliance, Mr. Perkins served as Director of Government Affairs & Legislative Counsel for the North Carolina Department of Health & Human Services. Before that, he served on Capitol Hill as Counsel and senior health policy advisor for a United States senator and members of Congress from 2008-2015.