The group that oversees how the state’s behavioral health services are administered will decide Tuesday whether to recommend dropping the company currently managing the system or to keep them on.
Judging by what state officials heard in a series of public hearings held around the state this spring, it appears the state is poised to keep Optum—for logistical reasons.
The decision whether to go out for a new, four-year $1 billion contract or stay with the current vendor, OptumHealth, will come at a special meeting Tuesday of the New Mexico Behavioral Health Collaborative at the State Capitol, Room 309. The meeting is scheduled for 12:30 p.m. to 2:00 p.m.
Health care providers and others across the state have told state officials in a series of recent public hearings that a transition would create havoc for those serving the state’s mentally ill and those struggling with substance abuse, as well as the people being served.
Those views were summarized last week at a meeting of the Collaborative, which hired the current contractor and oversees how services to the mentally ill and those dealing with substance abuse are managed around the state.
If the Collaborative recommends staying with Optum Care, the current contractor, it will represent a major shift for the state. Gov. Bill Richardson directed the Collaborative in late January to put the state’s $1 billion contract out to bid, a surprise announcement that came seven months into Optum’s troubled tenure.
Optum took over the state’s four-year, behavioral health contract in July 2009, replacing Value Options. But Optum’s performance quickly failed to live up to state officials’ expectations, especially after it was discovered that hundreds of providers statewide had to wait up to several months to get paid for services already rendered.
The problem was Optum Health’s electronic claims management system, which the company touted as a way to promptly pay nonprofits and others working with the mentally ill and those struggling with substance abuse. The system failed under the crush of real-world use soon after it went live July 1, 2009; the volume of invoices and claims that flooded the system were much greater than the test sample of claims the state used to conduct its readiness review.
Optum has since improved its performance, at least with many providers, according to some.