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Lifeways reports steady demand, raises alarm over new PIHP procurement
Summary
Lifeways told Jackson County commissioners it is meeting and exceeding internal encounter targets but is preparing for uncertainty from a newly released PIHP procurement and possible Medicaid eligibility changes.
Cassie Watson, executive director of clinical services at Lifeways, told the Jackson County Board of Commissioners that Lifeways averaged about 5,520 certified community behavioral health clinic encounters per month, above an internal target of 5,100.
Watson said Lifeways is developing an assertive community treatment team to serve people with high needs and high public-system costs and is working with residential providers to review high residential-service rates with a goal of cost containment through collaborative, not prescriptive, changes.
Why it matters: Lifeways is a community mental health services provider whose Medicaid and public-pay revenue supports local services. County commissioners were briefed so they could track potential impacts from state-level procurement and federal changes to Medicaid eligibility.
Watson told commissioners the state released the prepaid inpatient health plan (PIHP) request for proposals on Aug. 4 and that Lifeways and regional partners are reviewing the document. She said the RFP envisions a new PIHP region covering 33 counties with up to 15 seats on the PIHP board, a composition Lifeways worries may dilute county voices because a third of seats must be held by direct consumers and at least one by a family member of a youth receiving services.
On contracting, Watson said the RFP appears to allow the new PIHP to contract both with community mental health service programs (CMHSPs) like Lifeways and with other providers directly, creating uncertainty about where people will go for care and how services will be standardized.
Watson also described two pending policy changes the agency is preparing for. First, CCBHCs (certified community behavioral health clinics) will receive direct payments from the state rather than through the PIHP beginning Oct. 1; Lifeways is reorganizing staff and processes to handle that change. Second, Watson discussed federal changes affecting Medicaid enrollment that could lower the number of Medicaid-eligible residents, which would reduce per-eligible-per-month revenues for Lifeways; the agency is pursuing both cost reductions (a 3% departmental cut target was adopted internally) and revenue-generating activities tied to CCBHC encounters.
Commissioners asked when more clarity would be available. Watson said a bidders conference was scheduled the same day as the meeting and that the RFP submission timeline was short, with final proposals due in late September or October, so she expected clearer information within a week of those events.
A motion to receive the Lifeways quarterly report passed by voice vote.
