Funder: Centers for Medicare & Medicaid Services
Author: Allison Hamblin, Center for Health Care Strategies; and James Verdier and Melanie Au, Mathematica Policy Research
October 2011 | Brief
As states across the country seek new strategies to improve the coordination of physical and behavioral health services for high-need, high-cost Medicaid populations, there is an emerging array of options for doing so. In determining which integration model to pursue, states can either leverage existing capacity or pursue new care delivery systems to support fully integrated, patient-centered care.
This policy brief 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. It was developed by the Center for Health Care Strategies (CHCS) and Mathematica Policy Research for the Integrated Care Resource Center, a national initiative of the Centers for Medicare & Medicaid Services (CMS).
The brief details four models for integration, with various lead organizations serving as the core integrated care entity, including: (1) managed care organizations (MCOs); (2) primary care case management programs (PCCMs); (3) behavioral health organizations (BHOs); and (4) MCO/PCCM and BHO partnerships as facilitated by financial alignment. A description of each model is accompanied by examples of current state programs, considerations for implementation, and specific considerations for integrating services for beneficiaries who are dually eligible for Medicare and Medicaid.
States are encouraged to adapt these options based on their unique situations and advance new solutions for coordinating the delivery of physical and behavioral health care for high-need, high-cost Medicaid populations.
Visit the Integrated Care Resource Center for more information.