children's mental health services - amerigroup presentation
TRANSCRIPT
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Amerigroup GeorgiaChildren’s Mental Health
Services
Presented to: House Children’s Mental Health Study Committee
Presented by: Earlie Rockette, Regional Vice President, Special Programs
Amerigroup Georgia
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Our Team - 336 associates across 4 locationsAtlanta – Augusta – Savannah – Columbus
Geography159 counties (108 rural/51 urban) - 6 Medicaid regions• Atlanta - June 2006• East/North – September 2006• Southeast – October 2006• Central & Southwest – February, 2012
Membership: 373,962• 81.36% under 19 years of age - Average age: 12 • 1,100+ deliveries on average per month
Products• Temporary Assistance for Needy Families (TANF)• Children’s Health Insurance Program (CHIP)• Planning for Healthy Babies (P4HB)• Foster Care (GAFC)
Amerigroup Georgia
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Medicaid enrollees are sicker and have more disabilities than most other populations.
Source: Kaiser Family Foundation, “Medicaid Enrollees Are Sicker and More Disabled Than the Privately Insured.” (2004-2006).
Innovative Behavioral Health Programs
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1. Behavioral Health Workgroup and Integration Programs
Primary Goals: Ensure quality access to care
Integration of behavioral and physical health services
2. Psychotropic Medication Coaches Program
Primary Goal: Improve medication therapy outcomes for children on behavioral health agents
3. Complex Case Management/Care Coordination for Children with Behavioral health Challenges
Innovative Behavioral Health Programs (cont.)
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4. Expanded BH Provider network (LPC, LCSW, LMFP, Psychologist)
5. $5.8M CMS Innovation Grant: COACHES
6. Amerigroup Provider 360 (member health profile)
7. Telehealth with Georgia Partnership for Telehealth (BH highest users)
8. Creative Community Collaborations
Care Management Entities
Pathway to Permanency
Peer and Family Support Organizations
Together Georgia
Amerigroup’s Children Mental Health Data
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Total Enrollment as of October 2015 (age <21)
Overall total: 373,962
GF 360: 23, 000+
About Our Health Care Management
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• Primary care is a central and coordinating component• Every member chooses (or is assigned if needed) a Primary
Care Provider (PCP) and is then notified of that PCP by mail and by telephone.
• PCD available to all GF 360 members and all members in early 2016
• Support of 1st NCQA BH Specialty Practice in the Nation (Tentative Nov. 2015 – Georgia Hope)
• Every member receives reminders to access preventive care
• Members are contacted after frequent emergency department use, especially for minor conditions
• Behavioral Health Crisis Line 24/7• Process Improvement Program focused on ADHD/Antidepressants • Clinical Practice Guideline Monitoring (ADHD)
Multidisciplinary Team
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