[{"_1":2,"_88":-5,"_89":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6189462,"mediaKeyId","5057052-34ed8184789a7ba8f1a141eac7f721e1","parentId",5057052,"title","MPCA outlines phased Medicaid alternative payment methodology for Michigan health centers","audioSeconds",1980,"startMs",2175000,"endMs",4155000,"viewUrl","/Search/View?dp=1&key=5057052-34ed8184789a7ba8f1a141eac7f721e1&start=2175&end=4155","thumbnailUrl","https://assets.pipeline.soar.com/5057052-34ed8184789a7ba8f1a141eac7f721e1/thumbnail_2175000.jpg","articleUrl","/articles/6189462/Michigan/MPCA-outlines-phased-Medicaid-alternative-payment-methodology-for-Michigan-health-centers","mediaUrl","https://secure.pipeline.soar.com/6189462-3faf94cac7e0268b482e78920c40f634/orig.mp4?Expires=1771064266&Signature=TXGaSk~sH57c76yCmZHuji5yrkhOgEZMqjhblR4eW0C3E5iAozJY~1jirmf1EmUhqsHvp7Z5xk1kIUKy2OfbBJX-uipwnfHw3eCyNpIl3zR5IDjIyexxv9VGA848KLTwO3gmwTEk9mfJYYBIfONNq1lozDgHuZJJY72tvsHVi-2OWV3OUVpvtP-SRUtXDOEK2KMryLx~UfHQJOcz0SXsywI8KYmd3uf00I6LiCmIt9v3Ng2TcHiyEsjI0cSeX5hSkmStpQ7hzXYlEZdCTVcCjGlK08k2eU94OSddIzg2r5V-FgBDK4nU7fDW-qHEHqCwMGtDZqC2sY6pD7difHABPw__&Key-Pair-Id=KUT5TJCACFTXG","author","Michigan Legislature","date","2025-06-23T16:43:14Z","article","The Michigan Primary Care Association told the House Appropriations Subcommittee on Medicaid and Behavioral Health it is designing an alternative payment methodology (APM) for federally qualified health centers (FQHCs) that would change how Medicaid reimburses community health centers, enabling more team‑based and population‑focused care.

Philip Bergquist, CEO of the Michigan Primary Care Association (MPCA), said the APM work responds to limits in the current prospective payment system (PPS), which he said was established in federal law and adopted by Michigan in 2001 and now often fails to match the current cost and team‑based delivery of care. Bergquist said health centers save the Medicaid program money—citing a Michigan State University analysis that health centers save about $612 per Medicaid member annually and that statewide savings total roughly $170 million per year compared with other Medicaid providers.

What the APM would do: Bergquist described converting part of per‑visit Medicaid payments into a predictable monthly (partial capitation) payment for patients assigned to a health center, allowing centers greater flexibility to deploy nurses, community health workers, nutritionists and others as part of a care team. He said the model is designed with guardrails: health centers must not receive less total Medicaid reimbursement under the APM than under the traditional PPS, and the APM includes performance measures, monitoring of assignment and corrective‑action steps if centers do not meet outreach or utilization metrics.

Funding and timetable: testimony said the fiscal‑year 2024 Michigan budget authorized the APM design and provided $6 million in one‑time funding to start implementation planning—about $2 million to the Department of Health and Human Services (DHHS) to adapt state systems and about $4 million to the first health centers that will test the model. MPCA plans a phased rollout beginning in 2026 with an initial cohort of about five implementing health centers and five additional centers in 2027. The association requested additional one‑time funds to scale the transition to about 75% of Michigan health centers (MPCA estimated this phased scale would cost roughly $18 million; bringing all centers on board was estimated at about $25 million based on MPCA analysis).

Policy tradeoffs and oversight: Bergquist emphasized the APM is about “how” health centers are paid, not a direct increase in Medicaid rates; he said a prior budget action closed roughly one‑third of an estimated per‑visit funding gap, but the APM design itself does not increase the overall Medicaid payment envelope. Committee members asked about assignment rules and payment when assigned patients do not appear for visits; Bergquist said health centers would receive the partial capitation for assigned patients, but assignment comes with outreach responsibilities and performance measures such as an annual visit rate. He said corrective actions and the ability to exit the APM and revert to traditional PPS exist if a health center fails to meet expectations.

Operational requirements: MPCA and Bergquist described transition costs for participating centers including training staff, redesigning care processes and updating electronic health records and practice management systems. Bergquist said health centers estimate technology and redesign costs could be about one‑quarter of the per‑center transition budget and that the $6 million start‑up funds will primarily support initial implementers and DHHS readiness. He said the MPCA’s appropriations request for scale‑up would likewise be one‑time funding to support transition work rather than a recurring Medicaid rate increase.

Scope: Bergquist noted that not all services would move to the APM; school‑based services, dental care and many urgent‑care services that serve people who are not assigned to a health center would likely remain under encounter‑based reimbursement.

Ending: The committee followed with questions about monitoring, assignment accuracy, how outreach is conducted and whether mental‑health services in schools would be affected; Bergquist said assignment, performance metrics and corrective steps are central to preventing payment for unmanaged populations and that the design aims to be budget‑neutral to Medicaid while offering flexibility to improve care and reduce inpatient and ED utilization.

","mediaType","Video","parentTitle","Appropriations - Subcommittee on Medicaid and Behavioral Health - 6/24/2025","oneSentenceSummary","The Michigan Primary Care Association told the House Appropriations Subcommittee that a planned alternative payment methodology would shift some Medicaid reimbursement for federally qualified health centers from per‑visit rates to predictable monthly payments for assigned patients, enabling team‑based care while including performance guardrails.","taxTitle","2025 House Legislature MI, Michigan","taxId",77683,"location","Michigan","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6189464,"Mosaic Counseling urges expansion of school-based, low-cost therapy after Kent County rollout",2124,115000,2239000,"/Search/View?dp=1&key=5057052-34ed8184789a7ba8f1a141eac7f721e1&start=115&end=2239","https://assets.pipeline.soar.com/5057052-34ed8184789a7ba8f1a141eac7f721e1/thumbnail_115000.jpg","/articles/6189464/Michigan/Mosaic-Counseling-urges-expansion-of-school-based-low-cost-therapy-after-Kent-County-rollout","https://secure.pipeline.soar.com/6189464-a1ac8b02e6f19bb819bea936bdf42a96/orig.mp4?Expires=1771064266&Signature=QsOvCD72S5F3q7Z6KU52SDRIK0S4ufApRgtQRPKrvU6QIg-jUWMvZ7~NTg6oq7QUxE1XJ~Ucd4J~URzRbDUwPRebDp1jk2nAJmFJf5xj2um~3Lrh2IvDjayWHY7DMO58CwHSShCnBGXLGbGZ3EabPy0HaE02Ugd8LkgKkj~Ypmk1R8V9RlACwoQrkG3CkWCCppYcNb2N-wLb5Omg35Rh~bGwBgVu0cFbZCYdK-i3jH7J2N9OGFTA~jr8-Y8DlelcVE0YmZTES7STUMymO0aN1~lbYQpSLiAAdmeOuBxWFGFCwx6NB3DJnmYCh1LX7nMy06GfPHtDOYa0ggqOP08Ekw__&Key-Pair-Id=KUT5TJCACFTXG","The Michigan House Appropriations Subcommittee on Medicaid and Behavioral Health heard a presentation from Mosaic Counseling on the organization’s school-outreach program and a statewide expansion proposal, emphasizing rapid access to sliding‑scale therapy for students and community members.

Mosaic Counseling Executive Director Sarah Lukowski told the committee the group’s model places vetted private‑practice therapists into schools and community settings to remove barriers such as cost, wait lists and transportation. “We have never had a wait list regardless of insurance status,” Lukowski said, and she described a matching intake process intended to get people connected to an appropriate therapist “within a week or two” when a provider is available.

The presentation said Mosaic (founded in 1978) operates several programs: professional counseling for all ages, a school outreach program that serves students in seven school districts and 30 schools, an employee assistance program for employers and school staff, suicide‑prevention training using QPR (question‑persuade‑refer), and mental‑health advocacy. Lukowski said Mosaic has a panel of about 270 licensed private‑practice therapists who agree to reduced rates for Mosaic referrals; Mosaic’s lowest copay is $6 and the program’s negotiated rate with panel therapists is described in testimony as $60.

Why it matters: committee members pressed the group on rising need among children and adults and on Mosaic’s capacity to serve people regardless of insurance. Lukowski showed county survey data the group uses to target services and told members that mild‑to‑moderate adult mental‑health needs in Ottawa County rose from 17% (2020) to 27% (2023) in survey responses she cited. She said 34% of Mosaic’s clients last year were under age 18.

Committee questions covered data and operations. Representative Jennifer Robinson asked how Mosaic distinguishes “mild to moderate” from “severe and persistent”; Lukowski replied that severe and persistent diagnoses are conditions such as schizophrenia or bipolar disorder that generally require ongoing specialty services (community mental health) and medication and case management, while mild to moderate describes the broader set of needs Mosaic serves. Representative Rogers asked about payer mix; Lukowski estimated roughly one‑third uninsured/underinsured, one‑third Medicaid and one‑third private insurance, and confirmed the organization has expanded operations into Kent County.

Lukowski described partnerships that support referrals and continuity of care, including a collaboration with Forest View Hospital—an inpatient facility that discharges about 16 patients daily—and a new initiative to provide specially made cards to Grand Rapids Police Department patrol officers to give to people in crisis with direct scheduling information for Mosaic intake. She also said the state placed Mosaic back in the 2024 budget at $200,000 after prior funding pauses.

Committee members and the presenter emphasized prevention and crisis response. Lukowski said Mosaic provides crisis care in schools after events such as a death and has trained about 12,000 people through brief QPR suicide‑prevention sessions; she told the panel that QPR’s “refer” step is nationally constrained by limited outpatient capacity, which Mosaic tries to address by expanding provider panels and school outreach.

Operational details and limits: Lukowski said Mosaic’s staff is small—nine staff and three interns for Ottawa and Kent counties—but that the organization scales capacity through its vetted therapist panel. She said the portal Mosaic uses for intake and matching lets staff find available, appropriately credentialed therapists quickly and sometimes, in urgent cases, skip insurance to get a client seen the same day. Lukowski described telehealth as an important modality but did not provide a precise split for in‑person versus teletherapy for all services (she estimated telehealth is “probably 40%” for some services).

Next steps: Mosaic presented a budget proposal to expand into five additional counties (Ottawa, Kent, Muskegon, Jackson and Washtenaw were named) and asked for continued legislative support to help scale the model. Committee members invited follow‑up with more detailed payer‑mix, utilization and implementation cost data.

Ending: The presentation concluded with committee members thanking Mosaic for the overview and noting interest in school‑based mental‑health models as an element of broader behavioral‑health and Medicaid policy work in the House.

","Mosaic Counseling told the Michigan House Appropriations Subcommittee on Medicaid and Behavioral Health that its school-outreach and sliding-scale model—backed by a panel of private therapists—lets students get therapy quickly and without insurance barriers; the group seeks funding to expand into five more counties after receiving $200,000 in the ","actionData","errors"]

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MPCA outlines phased Medicaid alternative payment methodology for Michigan health centers

Mosaic Counseling urges expansion of school-based, low-cost therapy after Kent County rollout