- Kevin Mcguckin
As you are well aware, there is a proposal coming out of the Michigan Senate that would once again take up physical health/behavioral health integration. Much like the 298 process from a couple years ago, this new proposal would shift the Medicaid financing and managed care functions from the public PIHP system to private Medicaid Health Plans.
Most advocates believe the integration should begin and focus at the patient level on the ground not at the financial level and there must be public accountability / public governance in order to protect Michigan’s most vulnerable citizens.
The Senate continues to work on draft legislation that reflects the intentions laid out in the “Gearing Towards Integration” document. The bill(s) have not been introduced yet in the Michigan Senate, however, we believe they will be in the near future. There is concern that the bills will move quickly through the Senate. This proposal focuses on financial integration & appears not to do anything to actually integrate care other than giving the managed care functions and funding to one entity. The New Dartmouth Study shows that greater financial integration is generally not associated with better healthcare quality.
There is also concern that this new proposal lacks public oversight and accountability; it eliminates the PIHP system and dramatically reduces the role of the CMHSP system and all but eliminates public accountability. Many wonder why they are making this change in the middle of a pandemic, health care systems are currently stretched to their limits and this will only add to the stress and concerns of those served. The proposal just like section 298 simply makes the CMH just another provider for the managed care entity, which is a dramatic shift from what they do today. The proposal is not a public-private joint venture, but a wholly private managed care organization, leaving no role for the public management/oversight, which is currently provided by our PIHP system.
Lastly, the proposal timeline is a concern because it does not allow for any meaningful stakeholder involvement or buy-in which would bring greater success.
Please have an enjoyable summer.