History of Managed Care in Indiana
In 2007 the State of Indiana and Family and Social Services Agency (FSSA) converted the Hoosier Healthwise Program from a fee for service arrangement to one utilizing a managed care model. Mental health services were included in the transition to managed care as a part of a “carve in”. Under this model, qualifying children and pregnant mothers receive mental health services under Hoosier Healthwise only following managed care rules and payment processes as determined in the contract between FSSA and selected Managed Care Organizations (MCOs).
Because of the unique nature of behavioral health services, MCO’s subcontract with organizations specifically involved in the provision of insurance-related services for behavioral healthcare. In Indiana the following MCO’s are the only currently active health plans for Hoosier Healthwise:
Following Hoosier Healthwise Program’s lead, FSSA also applied the managed care model to the blind, aged, disabled and other qualifying populations under a new, combined program known as Care Select. Former Medicaid Select participants and others utilizing a “fee for service” model were combined into the Care Select program. Mental health services under this program were also “carved in”. The FSSA indicated its goals for this program is to use evidence-based medicine to manage services by duration, scope and severity; improve the quality of care and health outcomes for the ABD population; and control the continued increase of health care costs for the ABD population.
Similar to Hoosier Healthwise, MCO’s utilize a subcontractor arrangement to manage behavioral health services. The following MCO’s are the currently active health plans for Care Select in Indiana:
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