Gettysburg, Pa., June 17, 2019 (GLOBE NEWSWIRE) -- OPEN MINDS has released an updated suite of Medicaid market intelligence resources on the state of Idaho. The resources include analysis of the Idaho’s Medicaid system, Medicaid managed care vendor contracts, and additional state-specific information.

The Idaho Medicaid managed care program is called Healthy Connections. The contract is available for download.

Primary care providers (PCPs) act as gatekeepers for services, and program payments incentivize them to transform into patient-centered medical homes (PCMHs).

• Healthy Connections PCCM

Beginning in January 2019, PCPs will also have the option to serve Healthy Connections enrollees through accountable care organizations (ACOs) and shared savings arrangements.

In January 2019, Idaho plans to add shared savings and ACOs—called regional care organizations (RCOS)—to the Healthy Connections Program.

• Under the Shared Savings program, PCPs with at least a 1,000 attributed members will be eligible to participate in shared savings arrangements with no downside risk.
• Under the RCO program, PCPs will directly tie payment to the cost of care and quality.

The state has not released additional information on the programs at this time. The state plans to submit a state plan amendment detailing the program in the fall of 2018. It also has not released the application to become an RCO.

In order to facilitate the move to the new model, the state will move to fixed enrollment for PCP attribution.

• Currently, individuals are able to choose their PCP. If individuals do not choose within 30 days, the state Medicaid agency will assign them to a PCP based on their prior claims history and location. They can switch between PCPs at any time.
• Under fixed enrollment, all participants must choose—or they will be assigned to—a PCP beginning January 1, with a 90 day grace period. Individuals will only be allowed to change PCPs for very specific reasons, and all changes will be effective at the beginning of the month.

The Idaho Medicaid Managed Care Contracts are available now for all Elite OPEN MINDS Circle members. Individual contracts may be purchased in the OPEN MINDS shop for $1,500 each.

Additionally, the OPEN MINDS team has four in-depth profiles of the Idaho state health system:

• Idaho Health Care System Landscape: An OPEN MINDS State Profile, which provides information on each state’s largest health plans, Medicaid expansion policy, health insurance marketplace plans, demographics, population health insurance coverage by payer, and more.
• Idaho Medicaid System: An OPEN MINDS State Profile, which provides a detailed exploration of each state’s Medicaid financing system, including a review of the managed care financing systems, largest health plans by enrollment, key players in the state Medicaid department, and plans for future system changes and contract reprocurements.
• Idaho Behavioral Health System State Profile Report, which provides a comprehensive listing of behavioral health benefits in the state, care coordination programs related to behavioral health, and behavioral health subcontractors for health plans.
• Idaho Medicaid/Medicare Dual Eligible System: An OPEN MINDS State Profile, which provides an overview of each state’s dual eligible financing system, as well as the largest Medicare health plans serving dual eligibles and details on new initiatives involving the dual eligible population.

The Idaho suite of state profiles is now available now for the Elite OPEN MINDS Circle members. In addition, the OPEN MINDS team has a wealth of additional Idaho-specific resources. A monthly OPEN MINDS market intelligence update is available to all health and human services executives. To sign up, OPEN MINDS Circle members should set their email preferences under the My Account Settings.

All of these resources, and more, are available as part of an OPEN MINDS Circle Elite membership. Membership includes unlimited organizational access to all OPEN MINDS content and databases, plus executive education events, and other exclusive Elite member benefits. Learn more about becoming an Elite OPEN MINDS Circle member online at www.openminds.com/elite.

ABOUT OPEN MINDS

OPEN MINDS is an award-winning information source, executive education provider, and business solutions firm specializing in the domains of health and human services serving consumers with chronic conditions and complex support needs. For thirty years, we’ve been pioneers for change – helping organizations implement the transformational business practices they need to succeed in an evolving market with new reimbursement, competition, policies and regulations.

OPEN MINDS is powered by a national team of experienced executives and subject matter experts with specific expertise and experience in nine key market areas – mental health, addictions, chronic conditions, autism and intellectual/developmental disabilities, long-term care, children’s services, social services, juvenile justice, and corrections health care. Our mission is to improve the quality of care for consumers with complex support needs by improving the effectiveness of those serving them – provider organizations, payer and insurance organizations, government agencies, pharmaceutical organizations, and technology firms. Learn more at www.openminds.com

Sarah C. Threnhauser
OPEN MINDS
717-334-1329
info@openminds.com