Thresholds and IlliniCare Health Release Pilot Program Results That Improve Health, Decrease Costs for Medicaid Patients with Severe Behavioral Health Problems
Unique payer/provider partnership provides a model for Medicaid managed care and health coordination towards the “Triple Aim” of Affordable Care Act
Chicago, IL – Thresholds, Illinois’ largest provider of community-based services for persons with mental illnesses, and IlliniCare Health/Cenpatico, a subsidiary of Centene Corporation (NYSE: CNC), recently completed an innovative pilot program to improve the lives of IlliniCare’s most complex and highest-risk behavioral health patients.
Thresholds was paid a flat-rate to manage the care of the 50 most complex and highest-risk behavioral health patients enrolled in IlliniCare’s integrated care program. Many of these patients were not currently engaged in any sort of mental or physical healthcare services. Utilizing a strategy of “relentless engagement”, Thresholds’ team located the patients and built relationships that allowed them to engage in appropriate care specific to each individual.
This new personalized concept, combined with a flat fee that guaranteed payment, allowed Thresholds to creatively pursue the best options unique to each client. In a year-long pilot from March 1, 2013-February 28, 2014, Thresholds saw a 50% overall reduction in behavioral health admissions, a 55% reduction in 30-day readmissions, and a 58% reduction in 90-day readmissions. There was a 63% reduction in overall cost for psychiatric inpatient care.
“The results of the study are encouraging for the future of Medicaid managed care,” says Mark Ishaug, Thresholds CEO. “We hope to continue to deliver high-quality services that improve the lives of our clients through partnerships like this in the future, both with IlliniCare/Cenpatico and other managed care organizations. Together, we can improve lives, cut costs, and create an overall better experience of care for persons experiencing behavioral health challenges.”
Learn more about the tranformative effects of the pilot in this video showcasing Ruthie’s story:
Established in 1959, Thresholds provides healthcare, housing, and hope for thousands of persons with mental illness in Illinois each year. Through care, research, employment, advocacy, and housing, Thresholds assists and inspires people with mental illness to reclaim their lives. Thresholds is the oldest and largest provider of recovery services for persons with mental illnesses in Illinois. They offer 25 innovative programs at more than 70 locations throughout Chicago, the adjacent suburbs, and McHenry and Kankakee Counties. Services include assertive outreach, case management, housing, employment, education, psychiatry, primary care, and substance abuse treatment. Last year, Thresholds served more than 6,000 adults and youth, with 75% of services delivered out in the community, representing more than 400,000 hours of care. Learn more at www.thresholds.org or follow @thresholdsctrs on Twitter.
Cenpatico’s expertise lies in managing benefits for vulnerable populations. Our healthcare specialties include behavioral health, foster care, school-based services, specialty therapy and rehabilitation and more. We have managed Medicaid and other public sector benefits since 1994; currently, we serve nearly 3 million members nationally. Our headquarters are in Austin, Texas and we have local teams across the country in the markets we serve. Cenpatico is a wholly-owned subsidiary of Centene Corporation. We are committed to innovative solutions and designing programs tailored to improving functional outcomes with our members. Find us online at www.cenpatico.com.
About IlliniCare Health Plan:
IlliniCare Health Plan (IlliniCare) is a Managed Care Organization (MCO) contracted to provide services under Illinois Department of Healthcare and Family Services Integrated Care Program and the Medicare-Medicaid Alignment Initiative (MMAI). IlliniCare is a wholly-owned subsidiary of Centene Corporation (NYSE: CNC), a leading multi-line healthcare enterprise offering both core Medicaid and specialty services. IlliniCare currently serves over 20,000 members as part of the Illinois Department of Healthcare and Family Services Integrated Care Program (ICP) in Cook, DuPage, Lake, Kane, Kankakee and Will Counties. In 2013, IlliniCare expanded the Integrated Care Program to serve Boone, McHenry, Winnebago, Rock Island and Mercer Counties. The Department of Healthcare and Family Services recently named IlliniCare one of the six Managed Care Organizations to participate in the Medicare-Medicaid Alignment Initiative (MMAI) in the greater Chicago area. Information regarding IlliniCare is available at www.illinicare.com.
About Centene Corporation:
Centene Corporation, a Fortune 500 company, is a leading multi-line healthcare enterprise that provides programs and related services to the rising number of under-insured and uninsured individuals. Many receive benefits provided under Medicaid including the State Children’s Health Insurance Program (CHIP), Aged, Blind, or Disabled (ABD), Foster Care and long-term care, and other state-sponsored programs, and Medicare (Special Needs Plans).Centene’s CeltiCare subsidiary offers states unique “exchange based” and other cost-effective coverage solutions for low-income populations. The Company operates local health plans and offers a range of health insurance solutions. It also contracts with other healthcare and commercial organizations to provide specialty services including behavioral health, life and health management, managed vision, telehealth services, and pharmacy benefits management. More information regarding Centene is available at www.centene.com.