Medicaid Services Unit: NorthSTAR

Loading...

The NorthSTAR Program is a publicly funded managed care approach to the delivery of mental health and chemical dependency services to the eligible residents of Dallas, Ellis, Collin, Hunt, Navarro, Rockwall and Kaufman counties. NorthSTAR is under the direction of the Department of State Health Services. It provides a comprehensive mental health/substance abuse benefit package for all eligible individuals, and access to benefits is determined by clinical need, not funding source.

Client services to both eligible Medicaid and medically indigent individuals are managed under contract with the State by a behavioral health organization (BHO), ValueOptions. The DSHS contract with ValueOptions outlines the requirements for performance, and is rigorously managed. ValueOptions must spend at least 88% of their State payments on direct services. ValueOptions' clinical care managers individually review case presentations for clinical need, and make authorization decisions accordingly. ValueOptions also pays provider claims for service. An expanded provider network contracts with ValueOptions to provide authorized care. Providers compete with one another for market share, and in this competitive environment, enrollees are free to choose any appropriate provider for their behavioral healthcare needs.

The North Texas Behavioral Health Authority (NTBHA) serves as the local behavioral health (mental health and substance abuse) authority for the entire NorthSTAR service area, and functions include planning, oversight, single portal authority functions, as well as a local problem solving resource that includes ombudsman services.

The Unique NorthSTAR Approach

  • Blended funding - State and local agencies contribute wrap-around funds for a person's treatment. No longer does a person have to mine the various agencies and departments to receive services.
  • Integrated services - Mental health and chemical dependency treatment are coordinated under behavioral health, allowing integrated treatment in a single system of care.
  • Care management - Individuals receive the proper amount of cost-efficient care.
  • Data-based decision support - A modern data warehouse and decision support software is used to evaluate and manage the system of care.
  • Behavioral Health Organization - Services are provided via a fully capitated contract with a licensed behavioral health organization.

Documents

File viewing informationInformación de visualización de archivos

NorthSTAR RFP

NorthSTAR Enrollee Handbook and Provider Directory

NorthSTAR Bulletins

 NorthSTAR Quality Monitoring Strategies

NorthSTAR Rates

2013-2015 NorthSTAR Waiver

Presentations 

  • Loading...
Last updated August 08, 2014