(Washington, DC) – Today, the Department of Health Care Finance (DHCF) announced plans to integrate community-based mental health and substance use disorder services into the Medicaid managed care program and provide maximum flexibility in establishing the payment methodology used to reimburse health plans. This next phase of Medicaid reform aligns with the agency’s priority to build a health care system that provides whole person care and improves health outcomes.

In 2019, DHCF announced a five-year Medicaid reform effort to transform the managed care program into a more organized, accountable, and person-centered system for District residents. Since then, DHCF achieved its initial goals to increase expectations for value-based purchasing; increase access to care; and increase care coordination. Investments in health information exchange, practice transformation, and provider technical assistance to support reform are on-going.

DHCF is taking the next step toward a more integrated system by bringing in key behavioral health services into the Medicaid managed care program. Community-based intensive mental health and substance use disorder services are available to Medicaid beneficiaries today but are provided outside of the managed care program. Bringing these services into the managed care program supports better care coordination and whole person care and alleviates the need for beneficiaries to navigate multiple systems.

Deputy Mayor of Health and Human Services and DHCF Director Wayne Turnage commented, “This change signals a new level of accountability for the District’s managed care plans. Going forward, expectations for improved health outcomes will incorporate both physical and behavioral health and participating plans will be held to higher standards.”

This service expansion changes the scope of services required by managed care plans and represents a material change to the current contract. A new procurement will be issued as a result. DHCF, through the District Office of Contracting and Procurement, will issue a Request for Proposals (RFP) for managed care services inclusive of all levels of behavioral health services in November 2021.

The Department of Health Care Finance is the District’s State Medicaid Agency. The mission of the Department of Health Care Finance is to improve health outcomes by providing access to comprehensive, cost-effective and quality healthcare services for residents of the District of Columbia.