C2 – Making Friends: Forming partnerships between Providers and Payers

Summary

The opioid epidemic has impacted a viral hepatitis epidemic, HIV outbreak, and an increased prevalence of sexually transmitted infections increase among people who inject drugs. In order to move forward with integrated care strategies in a financially sustainable way, especially in an increasingly Value-based payment world, behavioral health providers need to look toward innovative reimbursement models and collaborations with payers. In this hour-long workshop, leaders in substance use disorder treatment, infectious disease care, and managed care organizations will present a unique partnership that has enabled a novel payment structure to support integrated care within a methadone maintenance clinic. This presentation will walk attendees through the current Medicaid carve-out payment structure in Pennsylvania; the goal for the physical health integration of a Methadone clinic in urban Philadelphia; and the development of organizational partnerships among the physical and behavioral health MCOs;. The current status and accomplishments resulting from this collaboration will be reviewed (e.g., metrics, access to data, novel reimbursement models, improved collaboration of care for individuals served). The target population for this program is program leaders and administrators who desire to move toward integrated service delivery models or policy makers who are interested in learning more about innovative approaches to reimbursement models.