Managed Care Academy
Customizing Medicaid Managed Care for Children, Youth and Young Adults with Behavioral Health Challenges
Facilitators: Sheila Pires, Human Service Collaborative; Suzanne Fields, The Institute for Innovation & Implementation
Maximum Number of Participants: Each state team is limited to a maximum of 8 people
Participants: Applicants are encouraged to think strategically about whom to include on their teams, given their particular population(s) of focus and objectives. Teams should not exceed 8 members. Teams may include leadership or key staff from the state Medicaid agency, as well as from Medicaid managed care organizations, child welfare, juvenile justice, mental health, substance use, and/or education, as well as family or youth leaders who have been closely involved in financing discussions related to the system of care and to the development/sustainability of family-and youth-run organizations. Team members should be designated decision-makers for the entities they represent. We encourage the inclusion of Medicaid managed care vendors on the Team but recognize some Teams may select to focus on procurement goals in which inclusion of those Medicaid vendors in all sessions may not be appropriate. If necessary, we can work with states to structure certain discussions to address any procurement-related concerns.
Description: This meeting is a practical, how-to working meeting for strategically selected teams from states. Teams will explore a range of managed care strategies relevant to children, youth and young adults with behavioral health challenges and their families and receive technical assistance from faculty and peers on a specific managed care project or issue that the Team is bringing to the meeting for consultation. Teams will leave the meeting with their own tailored managed care strategies to address the goals they identified. Interested states or counties must complete the application process to be considered for acceptance as there is limited capacity.
Based on our ongoing work with states, we expect that working sessions will address such topics as: what to include within Medicaid managed care Requests for Proposals (RFPs) and contracts to ensure appropriate customization for children and youth; population-based strategies, including management of sub-populations of children with intensive needs, such as those involved with child welfare or juvenile justice; youth substance use disorder issues; rate setting and risk adjustment; benefit design including evidence-informed benefits; provider network requirements; customized care coordination, levels of care coordination, and health integration approaches including intensive care coordination using Wraparound and health homes; data dashboards and data sharing; quality and measurement; and youth and family engagement in managed care practice and policy.