Integrated Managed Care
The Washington State Health Care Authority has begun implementing changes to the Apple Health managed care program. This is based on State Legislature to shift to a whole-person approach to care delivery. The approach is being rolled out by county and will eventually apply to the entire state of Washington.
Coordinated Care members in Apple Health Core Connections statewide, and Apple Health (Medicaid) members in Asotin, Benton, Chelan, Columbia, Douglas, Franklin, Garfield, Grant, Island, King, Kittitas, Okanogan, Pierce, San Juan, Skagit, Snohomish, Walla Walla, Whatcom, Whitman and Yakima counties have physical health, mental health, and drug and alcohol treatment covered under our plan. This new system is helping us better serve Apple Health members in our state.
For behavioral health crisis services, 24/7 crisis phone lines are available to support children and adults. Find the direct number specific to a member's county below, or call us at 1-877-644-4613.
|Member County||Behavioral Health Crisis Number|
|Cowlitz, Grays Harbor, Lewis, Pacific, Wahkiakum||1-800-803-8833|
|Asotin, Benton, Columbia, Franklin, Garfield, Kittitas, Walla Walla, Whitman, Yakima||1-888-545-3022|
|Chelan, Douglas, Grant, Okanogan||1-800-852-2923
|Island, San Juan, Skagit, Snohomish, Whatcom||1-800-584-3578|
|Clallam, Jefferson, Kitsap||1-800-843-4793
|Adams, Ferry, Lincoln, Pend Oreille, Spokane, Stevens
|Clark, Klickitat, Skamania||1-800-626-8137|
Children’s Crisis Services for Medicaid-enrolled children/youth through 20 years of age:
As these changes roll out, we’ll provide training and resources to keep you informed. For more member information visit the Benefits and Services page under our Member section, or call Provider Services at 1-877-644-4613.
For more information on Integrated Managed Care (IMC) and its implementation, visit the Washington State Health Care Authority’s web page Integrated physical and behavioral health care.
- Coordinated Care's External Critical Incidents Notification Form (PDF)
- HCA's FAQs: Why change Apple Health to an integrated care model? (PDF)
- North Central (Chelan, Douglas, Grant) Integrated Managed Care Presentation (PDF)
- Provider Forum: Integrated Managed Care Operations for North Central Presentation (PDF)
- Integrated Managed Care Clinical Symposium - North Central (PDF)
HCA is developing a standardized, non-encounter data guide to establish the non-encounter data set that will be required reporting as of January 2020.
This Behavioral Health Data System guide (PDF) includes:
- standard data definitions
- transaction formats and
- most of the non-encounter data providers were already reporting to the HCA.
All licensed and certified BHAs contracted with an MCO/BH-ASO should collect and report this data. This is true regardless of the funding source of the contract between the BHA and the MCO/BH-ASO. Both "in-network" BHAs and "out-of-network" BHAs contracted with an MCO/BH-ASO through a single case agreement need to report this data. However, if a BHA is not contracted with any MCOs/BH-ASOs then are not required to report.