Up to 80% of Medicaid spending is on approximately 20% of enrollees, particularly those with severe chronic illnesses and disabilities and the frail elderly. Improving the quality of care for these high-need populations can both improve health outcomes and better manage health care costs. CHCS works with Medicaid stakeholders to design, implement, and evaluate programs that address the needs of adults with chronic conditions and disabilities. The following subtopics link to related CHCS resources and initiatives:
This spotlight highlights UPMC Community Care
, a new program for Medicare beneficiaries with serious mental illness in Allegheny County, Pennsylvania. The program, which integrates physical and behavioral health care for enrollees, is based on a model of care piloted through CHCS' Rethinking Care Program.
As states across the nation explore ways to curb costs and improve quality for Medicaid's highest-need, highest-cost populations, the Pennsylvania pilot findings offer tangible strategies for doing so.
This policy brief discusses key elements of new service delivery models for individuals with intellectual and developmental disabilities and provides examples of such models now being implemented.
This brief describes two Pennsylvania regional pilot programs to integrate physical and behavioral health services for adult Medicaid beneficiaries with serious mental illness (SMI) and co-occurring physical health conditions.
This policy brief from the Integrated Care Resource Center explores promising state options for integrating physical and behavioral health services within managed delivery systems, including examples of current state programs and critical considerations for implementation.
CHCS commissioned this Faces of Medicaid analysis by Johns Hopkins University researchers to examine multimorbidity patterns among adult Medicaid beneficiaries with disabilities and explore the implications of specific patterns on hospitalization and cost. The analysis uncovers significant opportunities for prioritizing clinical interventions, including the need to integrate physical and behavioral health services.
This online toolkit is designed to share innovative approaches for integrating Medicaid and Medicare services. It offers policy-related materials, hands-on tools and templates to help guide state efforts, as well as resources from states that have successfully implemented integrated care programs.