Across the country, health care policymakers and practitioners are attempting to develop more integrated approaches to health care delivery, particularly for individuals with complex and high-cost needs. In Medicaid, such efforts may be confounded by the common practice of separately financing and managing physical and behavioral health benefits. Lessons from Pennsylvania’s Serious Mental Illness (SMI) Innovations Project point to new strategies for successfully integrating care in this context.

Two regional pilots in Pennsylvania, part of the Center for Health Care Strategies-led Rethinking Care Program, tested new strategies to integrate physical and behavioral health services for adult Medicaid beneficiaries with SMI and physical health conditions. An independent evaluation of the two-year pilot efforts has identified significant impacts on cost and quality outcomes, and promising strategies that could be implemented in other states to promote integration.

This 90-minute webinar described the innovative care management and integration approach behind Pennsylvania’s SMI Innovations regional pilots, highlighted key findings from the program evaluation, and addressed policy and operational lessons to help inform other state care management efforts.

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I. Introduction

Speaker: Allison Hamblin, Vice President of Strategic Planning, CHCS Allison Hamblin briefly described the impetus behind the national Rethinking Care Program that Pennsylvania participated in, provided context for the focus on physical/behavioral health integration, and introduce the speakers.

II. Overview of Pennsylvania SMI Innovations Project

Speaker: David Kelley, MD, Chief Medical Officer, Office of Medical Assistance Programs, Pennsylvania Department of Public Welfare David Kelley outlined the design of Pennsylvania’s SMI Innovations Project and the state’s goals of integrating care management for Medicaid beneficiaries with SMI and physical health comorbidities.

III. Evaluation Highlights

Speaker: Jung Kim, Researcher, Mathematica Policy Research Jung Kim, one of the evaluators of the SMI Innovations Project, reviewed the evaluation approach and summarized key findings from the three-year pilot.

IV. Frontline Perspectives

Reactors: John Lovelace, CEO, UPMC for You; LeeAnn Moyer, Deputy Administrator, Montgomery County Department of Behavioral Health and Developmental Disabilities; Fazlu Rahman, MD, Medical Director, Keystone Mercy Health Plan; James Schuster, MD, Chief Medical Officer, Community Care Behavioral Health; and Sandy Zebrowski, MD, Medical Director, Magellan Behavioral Health.