Spokane nonprofit Excelsior Youth Center has teamed with two companies to establish Integrated Managed Care Collaborative, a new network tool aimed at helping behavioral health organizations prepare for the integration of health care in the Spokane region.

Located at 3754 W. Indian Trail Road on Spokane’s North Side, Excelsior serves youth and their families through a variety of behavioral health, education, and therapeutic recreation programs and services.

Andrew Hill, president at Excelsior, says, “We formed the IMCC (Integrated Managed Care Collaborative) as a way of helping providers prepare for a private integrated managed care system, develop billing services, and report patient data differently,” he says.

The two other companies involved in the network are Lakebay, Wash.-based Xpio Group Health LLC, and Nashville, Tenn.-based Qualifacts Systems Inc.

Xpio is a technology and behavioral health consulting firm that provides services to state and community behavioral health and human services organizations.

Qualifacts Systems is a technology company that builds and implements software services and web based electronic health records and billing systems for behavioral health and human services providers.

Hill says the collaborative was formed to aid the state Health Care Authority as it moves to meet legislative direction under Senate Bill 6312.

Signed into law in April 2014, the bill stipulates that by 2020, all regions of the state will need to transition to an integrated system for physical and mental health, as well as substance use disorder services in the Washington Apple Health program, which is funded through Medicaid.

Prior to April 2016, Hill says, substance use, mental health, and primary care services were each funded separately.

“Previously, mental health was funded through regional support networks. Substance-use care was funded by the state and directly contracted with providers, and primary care was funded separately,” he says.

He adds, “The state’s first step toward health care integration was to combine mental health and substance use services. Regional support networks were dissolved in favor of creating regional behavioral health organizations that have since been working to merge the two care types ahead of the overall integration requirement.”

Hill says behavioral health organizations have decisions to make about the timeline to adopt integrated managed care, and the Spokane County regional behavioral health organization, which includes Spokane and several other Eastern Washington counties, has agreed to become a mid-adopter beginning Jan. 1.

He says after that date, funding for all three services will be rolled into agreements Health Care Authority has with five managed care organizations: Amerigroup, Community Health Plan of Washington, Coordinated Care of Washington, Molina Healthcare, and UnitedHealthcare Community Plan.

At least four managed care organizations will be selected to serve Spokane and surrounding Eastern Washington counties. 

Through IMCC, providers will have access to Qualifacts’ electronic health records technology, a system known as CareLogic. 

He says the system will enable those organizations to collect data on their care processes that can then be analyzed by Xpio, in order to help track patient outcomes and work toward continuing to improve patient care and experiences. 

“We’re inviting substance use and mental health providers that are contracted with BHOs to participate in the IMCC, but the network also is open to public and private providers,” he says. “We’re particularly interested in those that offer social determinate of health services, as we believe those contribute significantly to overall health outcomes.”

Hill says agencies can chose their level of participation in IMCC, either downloading the electronic health records software and participating in consultation and revenue management services, or just contributing information from their current data records to be used in further research.

“There are about 30-some BHO contracted providers in our region, and not all of them will see this collaborative as a needed service,” he says. “However, we do hope to draw in a majority of them over the next 18 months.”

Hill says enabling agencies to access the CareLogic technology through IMCC helps to reduce the cost of switching to an electronic health records system and to collect data on patient outcomes more easily.

“Excelsior was at one time a smaller organization, so we understand the struggles they go through in terms of access to resources and technology,” he says. “While most larger organizations will have an easy time with integration, many others will need the kind of support the IMCC can provide.”

Hill says the main goals of the partnership are to improve access to care, to offer new opportunities for providers to improve the quality of care, and to create a source for aggregate data. 

“It brings together many different organizations that each serve behavioral health needs in the community and allows us to advance and advocate together,” he says.

The IMCC has the potential to move into a larger vision of shared resources and improved care, Hill says.

“The health care system relies on smaller, niche care organizations to help divert patients from emergency rooms and services,” he says. “This system will help us showcase the ways in which BHO’s support and supplement the work larger health care providers are doing.”