Improving the quality and cost-effectiveness of publicly financed health care
Improving Medicaid Care Management for People with Serious Mental Illness in Pennsylvania
About four years ago, Shervene, a 43-year-old grandmother of two, was diagnosed with Type 2 diabetes that had gone unmanaged. She already suffered from spinal disc degeneration and had difficulty walking. She fell into a severe depression, staying at home with her curtains drawn and not even bathing. Shervene, who receives Medicaid based on her disability, was hospitalized half a dozen times over a short period. She says she felt overwhelmed in trying to navigate the complicated health care system.
Her mental health therapist suggested she contact a new, county-sponsored demonstration program called HealthChoices HealthConnections (HCHC), begun in 2009. The goal of the program - a partnership between three southeast Pennsylvania counties, Magellan Behavioral Health, and Keystone Mercy Health Plan - was to better coordinate care while reducing costs for high-need, high-risk Medicaid beneficiaries with serious mental illness and chronic physical conditions. A similar demonstration, called Connected Care, was started in Allegheny County in southwest Pennsylvania around the same time. "I figured, why not give it a try," says Shervene.