March 25, 2019        Login     
 HomeHealthChoices Background   

On February 1, 1997, the Commonwealth of PA introduced a new integrated and coordinated health care delivery system, known as the HealthChoices Program, to provide medical, psychiatric and substance abuse services to Medical Assistance recipients. The program was started in Philadelphia and 4 surrounding counties in 1997, and phased in to other counties over the next ten years. HealthChoices is a mandatory managed care program for individuals receiving Medical Assistance.

The physical and behavioral health components of the HealthChoices Program were implemented through separate procurements. Counties were offered the option to manage the behavioral health program within their respective counties. Some chose to exercise this option while other counties did not.

The following represents the phasing in of the behavioral component of HealthChoices:
Feb. 1, 1997 Southeast, 5 counties
Jan. 1, 1999 Southwest, 10 counties
Oct. 1, 2001 Lehigh/Capital Area, 10 counties
July 1, 2006 Northeast Region, 4 counties
Jan 1, 2007 North Central, State option, 23 counties
July 1, 2007 North Central, County option, 15 counties

On July 1, 2006 the HealthChoices Program was implemented for behavioral health services (mental health and drug and alcohol) in Northeastern PA, specifically Lackawanna, Luzerne, Susquehanna and Wyoming counties. This program now serves over 140,000 Medical Assistance eligible individuals in the four county region.

These counties accepted a contract with the Department of Human Services (DHS) and have delegated the management of the project to the Northeast Behavioral Health Care Consortium (NBHCC) to manage the project on the counties’ behalf. NBHCC, a non-profit company, is responsible to manage the mental health and drug and alcohol services provided to medical assistance recipients after July 1, 2006. NBHCC receives a fixed capitated amount of funds (based on actuarial projections) to serve the needs of all of the residents in the four county area.

The goals of the DHS, and NBHCC, are to: (1) improve access to services, (2) improve quality of services, and (3) control costs. NBHCC has planned for many years, and explored many options in designing our structure, and we have been successful in expanding and enhancing our services through prudent management and close monitoring of the program. NBHCC has engaged Community Care Behavioral Health (CCBH), a recognized and experienced managed care organization, in designing and delivering the best services in the most efficient manner.

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