The 2020 OPEN MINDS Management Best Practices Institute opend with an informative keynote address by MaryAnne Lindeblad, state Medicaid director of the Washington Health Care Authority (HCA), "The Path From Behavioral Health Carve-Out To Integration." My takeaway from the keynote? The effort required to move to a new integrated service delivery system model is vastly under appreciated. Although integrated systems can reach their potential eventually-planning around design, procurement, engagement, and monitoring is key. And, Washington State is proof of success. To date, findings from the Southwest Washington region showed nine out of 17 clinical indicators noted statistically significant improvements (including substance abuse treatment penetration, emergency department follow up after substance use disorder dependence, and follow up after emergency department visit for mental illness within seven days to name a few). Satisfaction among clinical staff has improved, and the state has been able to achieve a small savings over the four-year period.

In 2016, Washington State began its move from a nine-region system with county-centered behavioral health care authorities to a system of managed care organizations with integrated physical and behavioral health for all Medicaid consumers. Starting the transition with just one region in 2016, as of January 2020, all ten regions are now live with a fully integrated managed care model.

But what goes in to managing an integrated system of care? Ms. Lindeblad's "behind-the-scenes" review of their process gave us more insight into the key requirements-navigating design and procurement issues, stakeholder engagement, health plan accountability, and provider system transition. Read more here.