Partnership provides mental health services

In 1997, five Oregon counties – Lincoln, Benton, Deschutes, Jefferson and Crook – formed an inter-governmental group called Accountable Behavioral Health Alliance (ABHA). The organization delivers managed-care mental health services to the 22,600 county residents covered by Medicaid.

In an effort to provide efficient mental health care, ABHA formed a partnership with a private managed behavioral health company, Lake Oswego, Ore.-based PacifiCare Behavioral Health (PBH), a subsidiary of Pacific Healthcare. Although ABHA assumes full financial responsibility for inpatient and outpatient mental health treatment, PBH retains all administrative duties.

The services provided by PBH include: – Overseeing the quality of care within ABHA’s guidelines;

– Reviewing services used by inpatient participants;

– Clinician training (with continuing education credits);

– Overseeing the ABHA member complaint and grievance process;

– Handling crisis calls via PBH’s 24-hour, seven-day-a-week call center; and

– Submitting shadow billing to the state to meet state and federal requirements.

The private/public partnership has proven beneficial for ABHA. The organization, through one administrative structure, has provided mental health services for more than 3,000 Medicaid patients in 1999, a 50 percent increase since its partnership with PBH. The partnership has helped ABHA lower costs by using PBH’s software system for reporting and recording functions. The organization also has built its panel of practitioners and has decreased patient hospitalization as a result of better communication between county clinics and hospitals.

Future plans for ABHA include extending its services to children and adolescents under managed care by working with a state pilot project. One county has initiated a peer counseling program, and other counties have started clubhouse programs, which promote employment and recovery for patients with severe and persistent mental illness.