Individuals with serious mental illness (SMI) have higher rates of physical health conditions than the general population, and health care systems often struggle to meet their needs. Recent efforts to improve health outcomes for this population have focused on physical and behavioral health care coordination. Yet despite growing consensus that care coordination leads to better outcomes, there is little evidence of how to best do it among Medicaid beneficiaries with SMI.
This article, from the American Journal of Managed Care, provides an overview of the implementation of Connected Care, a care coordination improvement effort of managed care partners in southwest Pennsylvania for adult Medicaid beneficiaries with SMI. The collaborative, implemented as part of CHCS’ Rethinking Care Program, sought to enhance care management, member education, and information sharing between payers and providers through multidisciplinary case review meetings as well as real-time notifications of hospitalizations, emergency department visits, potential care gaps, and medication refill gaps. The article highlights project experiences and outcomes to inform future managed care and system-level efforts to coordinate physical and behavioral health care in Medicaid.