Aligning Medicaid payment reform
To ensure payment reform and quality, Montana Medicaid State Innovation Model grant staff is working with our QIN-QIO Mountain-Pacific Quality Health, executive leadership and consultants to assure that Medicaid payment reform aligns with MACRA. Through this alignment, we build visibility—bringing payers, key stakeholders and consumer groups to the table. This collaboration creates synergy around the following top priorities:
• Committing resources to develop a viable health information exchange that includes all payers.
• Promoting integrated behavioral health models, including the Billings Clinic Project ECHO model, launched in January as the first Montana-based hub. Project ECHO, Billings Clinic is utilizing this model to establish a collaborative and peer support for addiction and behavioral health clinicians working within the Department of Corrections to care for offenders who are incarcerated or transitioning back into the community.
• Reducing readmissions in rural settings using a model based on the Camden Coalition of Healthcare Providers. This model focuses on patients known as “super-utilizers” of the health care system. One percent of these patients can account for more than 20 percent of total health care expenditures. They usually have multiple chronic conditions, emergency department visits, hospital admissions, mental health concerns, substance abuse concerns and/or complex social barriers to receiving care.
• Continuing to educate patients and families so they have the information they need to make informed choices. Patient and family engagement should be the cornerstone of health care quality and reform with the end results being better care, smarter spending and healthier people.