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2.6 Improved Care Coordination and Transitions between Levels of Care

Milestone Criteria Current State Future State Summary of Actions Needed Additional policies to Current certification Wisconsin Medicaid Wisconsin Medicaid ensure coordination of | requirements for will continue to will revise acute care for co-occurring community SUD evaluate the array of managed care physical and mental treatment programs services carved into its | contracts by January health conditions include requirements risk-based managed 2020 and conduct for assessment, referral, | care contracts to further | ongoing monitoring and aftercare services integrate physical and | through managed that are designed to mental health services. | care provider ensure all health needs | The new residential network and quality for an individual in SUD benefit will be monitoring. treatment are identified | carved into acute and addressed. managed care plans effective January 2020 Wisconsin Medicaid to ensure coordination integrates the majority | between physical and of behavioral health behavioral health services into its risk- services. based contracts for managed care. This Wisconsin Medicaid approach to contracting | will also identify ensures the managed opportunities to care entity meets develop more intensive coverage requirements | care coordination for both physical and models for individuals behavioral health with SUD, including conditions and health homes or other coordinates services intensive care across these domains. coordination models. Initial analysis of the health home model for enhanced core coordination for individuals with SUD will be completed in 2020.

3.0 Implementation Administration

Please see below for the Wisconsin Medicaid’s point of contact for the Implementation Plan.

Name and Title: Sophia Lee, Behavioral Health Analyst, Division of Medicaid Services Telephone Number: 608-266-2901

Wisconsin BadgerCare Reform Demonstration Approval Period: October 29, 2024 through December 31, 2029

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