Funder: The Commonwealth Fund

Author: Maia Crawford and Rob Houston, Center for Health Care Strategies

February 2015 | Brief


States are realizing the potential benefits associated with integrating medical care and social services, and are beginning to take the first steps toward developing financing and payment models that encourage this connection. While models for integrating health and social services are still emerging, states are eager to develop programs to reap the potential health and cost benefits of integration and build a more effective and sustainable health care system.

This brief, made possible by The Commonwealth Fund, reviews potential financing mechanisms to facilitate integration, with a particular focus on Medicaid. Drawing from interviews with experts across the country, it offers models ranging from one-time seed funding for pilot projects to blended or braided financing arrangements that support comprehensive integration.

A previous Center for Health Care Strategies-authored brief for The Commonwealth Fund, A State Policy Framework for Integrating Health and Social Services, described the initial building blocks states need to integrate health and non-health services: (1) a coordinating mechanism; (2) quality measurement and data-sharing tools; and (3) aligned financing and payment. This brief focuses specifically on the third component — financing and payment — offering a menu of options for states to create financial incentives for integration, particularly for Medicaid populations. It offers ideas for paying for health and social service integration, including examples of financing mechanisms and sources (where the money comes from) and payment methodologies (how the money is disbursed to providers).