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Press Release

WellCare Signs Behavioral Health Home Agreement with Georgia HOPE

WellCare Health Plans
Posted on: 26 Jul 17

ATLANTA and TAMPA, Fla., July 26, 2017 /PRNewswire/ -- It has been documented that those living with severe mental disorders, such as schizophrenia, depression, bipolar disorder or other psychotic disorders, experience shorter lifespans compared to the general population. However, the majority of these deaths are primarily due to preventable physical health conditions, which go untreated.

To better meet the needs of those suffering from chronic conditions and mental illness, WellCare of Georgia, a subsidiary of WellCare Health Plans, Inc. (NYSE: WCG), partnered with Georgia HOPE to establish a behavioral health home.

While not an actual 'home,' a behavioral health home is an approach that connects all providers and specialists together to ensure the whole health of an individual is being met.

Research shows that individuals with severe mental disorders who are participating in a behavioral health home are more likely to access primary care services, and therefore, avoid preventable conditions.

Georgia HOPE, a qualified behavioral health home provider, will provide behavioral health services and ensure collaboration with and linkage to medical services for WellCare's Medicaid members identified as having severe medical and behavioral health issues, including those with a formal diagnosis of SMI, SED or substance use disorder (SUD).

The most recent data compiled by the Substance Abuse and Mental Health Services Administration (SAMHSA) indicates that approximately 5.4 percent of U.S. adults 18 and older experience serious mental illness (SMI), meaning their condition restricts daily functioning in their job, family, school, etc. The term for children in this category is severe emotional disorder (SED). SAMHSA's estimates indicate that 11 percent of children experience an SED.

"Our members' health care is our top priority, and we must ensure they get the right care at the right time in the most appropriate setting," said Dr. Sultan Simms, behavioral health medical director, WellCare of Georgia. "Georgia HOPE's member-focused model of care aims to improve health outcomes for those living with complex medical and behavioral health challenges by working collaboratively with primary care doctors and specialists."

Georgia HOPE, based in Dalton, Georgia, provides an integrated network of family preservation services, behavioral health services and substance use services throughout 21 counties in Northwest Georgia. In 2015, Georgia HOPE became one of the first behavioral health providers in the nation to be recognized as a Patient-Centered Specialty Practice. Georgia HOPE achieved the highest level awarded by the National Committee for Quality Assurance (NCQA), a nonprofit organization that accredits and certifies health care organizations. 

To further aid in improving health outcomes and providing a better care experience for WellCare's members, Georgia HOPE will also be incentivized for quality-based improvements in certain Healthcare Effectiveness Data and Information Set (HEDIS) measures, a tool used by more than 90 percent of America's health plans to measure performance on important dimensions of care and service.

"We are thrilled to partner with WellCare to establish its first behavioral health home in Georgia," said Nikki Raymond, CEO, Georgia HOPE. "The fact is that individuals who suffer from severe psychiatric issues are at a greater risk for hospitalization and/or medical ailments. Our commitment to high-quality integrated health care aligns with WellCare's behavioral health home model to improve health outcomes for the individuals in our community. Beyond our commitment to high quality is a culture that fosters a holistic approach in the way we, as clinicians, view our clients. We hope that by seeing our clients through this lens, we ensure their physical, mental and social needs are met in a coordinated way. Ultimately, we are working alongside them to increase life expectancy and improve wellness."   

As of March 31, 2017, WellCare serves approximately 579,000 Medicaid and PeachCare for Kids® plan members, 44,000 Medicare Advantage plan members and 20,000 Medicare Prescription Drug Plan members in Georgia. To learn more about how WellCare cares for Georgians, watch Gloria's story at

About WellCare Health Plans, Inc.
Headquartered in Tampa, Fla., WellCare Health Plans, Inc. (NYSE: WCG) focuses exclusively on providing government-sponsored managed care services, primarily through Medicaid, Medicare Advantage and Medicare Prescription Drug Plans, to families, children, seniors and individuals with complex medical needs. The company serves approximately 4.1 million members nationwide as of March 31, 2017. For more information about WellCare, please visit the company's website at or view the company's videos at

Editor's Details

Mike Wood

Last updated on: 26/07/2017

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