The state’s new approach to revamp mental health services proposes to unite elements offered by entities that have been at odds with each other—private insurance companies and public behavioral health organizations.

Roughly two months after the Department of Health and Human Services ended the direct blending of physical and mental healthcare, DHHS Director Robert Gordon briefed lawmakers on a new physical-mental health integration approach.

Part of the proposal is the idea of creating multiple “specialty integrated plans” or SIPs, which the DHHS said in a press release today would “bring together the management skills of traditional insurance companies with the expertise and depth of behavioral health organizations.”

The association for the state’s Community Mental Health agencies would run at least one plan offering these services to the public.

Gordon also suggested other plans be created, like one controlled by private Medicaid health plans and another one led by providers and hospitals, as examples.

The DHHS director stressed to a joint hearing of the House and Senate DHHS appropriations subcommittees that many details of the plan are to be determined and that the department plans to get feedback during four public forums in 2020 to fully design the plan. He wants the whole system to be implemented by 2022.

Bob Sheehan, CEO of the CMH Association of Michigan, said what he likes about Gordon’s vision today is that no matter what happens, a public plan is intended as part of the system.

That was the sticking point for the local public CMHs in the physical-mental health integration debate that’s played out the past few years. In MIRS, it’s been referred to as “Section 298” after the applicable DHHS budget boilerplate language.

Under former Gov. Rick Snyder, a provision had been proposed to allow the state’s private Medicaid physical health providers to also take on mental health services. The backlash from the CMHs and other mental health stakeholders caused the Snyder administration to pull back from that.

In the past few years, the CMHs and the health plans have been at odds over how pilot projects testing out physical-mental health integration should be designed.

But with Gov. Gretchen Whitmer vetoing Section 298 completely in the Fiscal Year 2020 budget, and the two sides not having found common ground, DHHS killed the pilots in October.

Sheehan said there are things about Gordon’s proposal that has CMH members concerned—namely, the possibility of other plans offered alongside the public option.

Sheehan said CMHs are not afraid of competition. What he is afraid of is marketing efforts that attempt to woo away patients, not because that plan is better quality, but because the marketing makes it “quite attractive.”

Right now, Gordon said when it comes to serving people with significant behavioral health needs, physical health needs are served by Medicaid health plans, and specialty behavioral health is served by prepaid inpatient health plans (PIHPs), which turn around and contract with CMHs to provide services.

And among the various regions that Michigan is carved up into for these purposes, there’s only PIHP per region. Sheehan argued that while there may be just one plan per region, patients typically pick their care by the provider, not by the plan.

At the hearing Dec. 4, Rep. Phil Green (R-Millington) asked specifically if Gordon was proposing having a public plan compete against a private plan. Gordon said there would be a public option, plus several other options.

This story courtesy of MIRS, a Lansing-based news and information service.