The Provider-led Arkansas Shared Savings Entity (PASSE) – a new model of organized care created by Act 775 – addresses the total health care needs of Medicaid beneficiaries who have behavioral health (BH) disorders or intellectual developmental disabilities (IDD). The purpose of the model is to improve the health of those who need intensive levels of specialized care, link providers of physical health care with specialty BH and IDD providers and coordinate care for all community-based services.
Arkansas Medicaid spends $1 billion annually to care for about 30,000 high-needs beneficiaries with BH conditions and IDD. These beneficiaries will receive an independent functional assessment to identify needs and the results of the assessment will be used by the PASSEs to develop care coordination plans.
The PASSE model will be implemented in two phases.
Phase 1 of PASSE began October 2017 with PASSEs becoming licensed. The PASSE will develop patient-centered service plans based on independent assessments. Beneficiaries will be assigned to a PASSE in January 2018 and begin receiving care coordination. Their provider’s care will not change. PASSEs’ networks include independent primary care physicians, specialists, behavioral health providers, patient-centered medical homes, federally qualified health centers, rural health centers and pharmacists.
The Arkansas Department of Human Services (DHS) will continue to reimburse fees-for-services until Dec. 31, 2018. On Jan. 1, 2019, PASSEs become responsible for total care costs and will receive global payments per member, per month to cover administrative costs and benefits for IDD patients.
In Phase II, PASSEs will partner with community providers of specialty and medical services. As a risk-based provider organization, it will perform the administrative functions of managed care. This new business organization will function as an insurance product; certified and regulated by the Arkansas Insurance Department.
PASSEs must operate statewide, but provider participation is voluntary. The DHS encourages providers to join multiple PASSEs. PASSEs cannot require providers to financially invest in the PASSE; however, a provider may make the business decision to do so.
PASSE will serve patients by:
- Coordinating providers and total care for IDD and BH patients
- Linking and organizing acute care with behavioral health, long-term services, and community-based social and developmental support
- Preventing under- and over-utilization of services
- Using expensive acute services such as inpatient psychiatric placement only when necessary
- Enhancing the array of services available to beneficiaries
- Increasing the number of community service providers
For more information visit the PASSE webpage: https://www.medicaid.state.ar.us/general/programs/passe.aspx