Aetna Better Health of Illinois Connecting Children to Care

26 Mar 2021 3:30 PM | IAMHP Support (Administrator)

February 2021

Childhood and adolescence are critical stages of life for mental health.  This is a time when rapid growth and development take place in the brain.  Children and adolescents acquire cognitive and social-emotional skills that shape their future mental health and are important for assuming adult roles in society.

This is why the Illinois Association of Medicaid Health Plans (IAMHP) partnered with the Medicaid Managed Care Organization Aetna Better Health of Illinois (ABHIL) to discuss their approach to holistic care management for children with behavioral health care needs through partnership with families and providers to ensure children have access to the care they need, when they need it. 

“Member’s needs were not being met under the traditional model.  I want to applaud Aetna Better Health of Illinois for thinking outside the box and for partnering with providers, like us, to provide for member’s needs in a more holistic fashion”

 - Bernadette May, Executive Director of Family Service Association of Elgin

To view the presentation on Children’s Behavioral Health: Connected through Care, visit the IAMHP Video Library or check out our question & answers to catch the highlights from the webinar. 

Q:  Quickly summarize Aetna Better Health of Illinois’ approach to care management for children’s behavioral health.

A:  Given the needs of children it is important to be flexible and adaptable.  This includes having families, community organizations and Health Plans at the table working through the continuum of care to ensure care is delivered at the right time by the right people.  That is why ABHIL created a dedicated children’s care management team specialized in the integration of care that ultimately wraps care around the children, the families, and the community so they have the supports they need to flourish.  ABHIL also wanted to align ourselves with crisis providers to ensure a seamless experience for the members, which is why we partnered with providers such as, Family Service Association of Elgin. 

Q:  What changes and improvements have you seen since increased partnership between FSA and ABHIL?  What lessons can you share from this partnership that attendees could benefit from? 

A:  We have seen increased communication and shared clinical information that is important for continuity of care.  Things to take away would be that partnership among the provider, health plan, and member allow for a holistic treatment plan to be put into place.

Q:  What changes have you seen in mobile crisis response in the past year given COVID? 

A:  We have seen the MCR providers make effective and timely transitions to providing telehealth services.  This has increased satisfaction from both the providers and the members.

Q:  What questions do you think the health care community needs to be asking itself in order to improve quality and care within Illinois?

A:  How do we keep the ancillary members of a child or member’s life at the table and contributing to the member’s holistic well being?  For children specifically, how do we ensure continuity of support at school and in the community?  How can we prevent fragmentation of services to support the person, the family and the community?

Q:  As attendees ruminate on this presentation what would you say is the most crucial item for them to contemplate or consider? 

A:  The most crucial item to consider is the support for a child.  Support will mean something different to every individual, but that’s what makes it so crucial.  Is something as simple as a journal enough to help the child feel more at peace, is ensuring that the child’s coach attends IEP meetings what makes their interests feel validated, or is it that the mother needs a ride to the grocery store so the family can eat?  Children don’t exist in a vacuum, especially in a behavioral health crisis, so we wrap them in support (providers, people, places and things/resources) that are beneficial and member centered.

Learn about the latest news & insights on Illinois Medicaid for healthcare providers and healthcare advocacy groups by visiting our website IAMHP.net. 

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