What They’re Watching: Emily Jenkins
Emily Jenkins is the CEO of the Arizona Council of Human Service Providers. Jenkins joined State of Reform for this edition of “What They’re Watching” to talk about lessons she would share with other states on integrating physical and behavioral health care.
“We lost our behavioral health carve-out, so all of the behavioral health services that are publicly funded are going to be funded and provided through the provider network of the physical health plans. So, this has been a huge transition.
We have had huge problems with getting claims paid. Although the patient transformation, systems transformation seems to have gotten done relatively well, the burden’s been on the providers, financially, and we are very sensitive to keeping the provider network intact.
The other thing is that they changed the payment methodology on the same day as the systems transformation. So from years of having capitated, upfront payments, we’re mostly going to fee-for-service — which exacerbated the cash-flow issues for the providers. So, I think that trying to… How much reform can a system, kind of, absorb with a complete change in contracting?
The other thing that was really difficult — because we now have, for example, in Maricopa County the providers are dealing with seven health plans and a RBHA. So that’s a lot of payers, all doing things differently. In other parts of the state, there may be two or three. So, this was a change in business practice: You didn’t know if they wanted to contract with you or not. So, when they didn’t get back to you — it was July or August and you hadn’t heard from them in May — you didn’t know if they wanted to contract with you or not. So, how far do you push? And, what are you pushing? So, it created, really, some difficulties.
So, if people are going into these kinds of transitions, I think there are things that they need to make very clear to their agency — the state agency that’s administering this — about making sure that things are tested and the contracts are reviewed, so that they cover the range of business that the provider and the health plan would be engaging in.”