Legislation passed in 2014 mandating that every county in Washington State transition to Fully Integrated Managed Care (FIMC) under the current Medicaid system by 2020. In simple terms, it means Apple Health (Medicaid) is shifting to whole-person care. Taking it a step further, it means that care is coordinated so that people get the help they need, for body (physical health) and mind (behavioral health, which includes mental health and drug or alcohol treatment). Fully Integrated Managed Care, or FIMC, is the shift to whole-person care.

Integrated managed care is first and foremost about improving the health and care of clients. The changes integrate behavioral health benefits into the Apple Health managed care program so that clients have access to medical and behavioral health services through a single managed-care plan.


Here in North Central Accountable Community of Health, we’ve been working to bring FIMC to all four counties since 2017. On January 1, 2018, Chelan, Douglas and Grant Counties adopted FIMC as part of NCACH’s commitment to whole person care. On January 1, 2019, Okanogan County will transition to FIMC as well. While Apple Health and FIMC are regulated by the Washington State Healthcare Authority, NCACH has been working to support primary care and behavioral health care providers through the transition process.

In an effort to share best practices and lessons learned from North Central providers who’ve already transitioned to FIMC, North Central behavioral health providers and NCACH recently hosted a “FIMC Provider Site Visit.” All of the behavioral health providers in the North Central region participated in this event, which is a testament to their commitment to collaboration and supporting one another, not only regionally, but statewide. We had over 60 attendees from across the state and received overwhelming feedback that the session was extremely helpful. Many attendees expressed appreciation to our providers who gave their time to pay it forward.

A huge “Thank You” to the agencies that participated during our FIMC Provider Site Visit:
Grant Integrated Services
The Center for Alcohol and Drug Treatment
Children’s Home Society of WA
Confluence Health
Catholic Charities
Columbia Valley Community Health

Preparing Okanogan County for FIMC

In Okanogan County, NCACH is utilizing the already existing Coalition for Health Improvement (CHI) meetings in Okanogan County for broader stakeholder engagement and communications about preparations for the FIMC transition. NCACH intends to provide updates at each CHI meeting throughout this year. The next CHI meeting is August 20, 2018 and is open to anyone living or practicing in Okanogan County.

NCACH is also facilitating monthly Okanogan County FIMC Provider meetings. Okanogan County-based providers and Managed Care Organizations (MCOs) are invited to a meeting the second Tuesday of each month to allow for planning and updates on the FIMC transition in Okanogan County. NCACH intends to continue monthly meetings through December 2018. Future planned topics include the Early Warning System, understanding American Indian/Alaska Native Medicaid benefits, further refining the client communications plan, and a presentation from the Behavioral Health Ombuds in the region, among many others.

Interested in learning more? Join NCACH at the next Okanogan County CHI meeting.

To learn more about Fully Integrated Managed Care, please visit: https://ncach.org/fimc/