Integrated Care Improves Outcomes for Opioid Use Disorder in West Virginia
Elevance Health’s affiliated Medicaid managed care plan in West Virginia reduced rates of overdose, self-harm, and Neonatal Abstinence Syndrome (NAS) for members with opioid use disorder (OUD) through integration of behavioral and physical healthcare.
West Virginia experiences higher rates of OUD and NAS compared to the national average. Medicaid members, in particular, experience higher prevalence of OUD and often face challenges in accessing healthcare, such as limited transportation. Integration of physical and behavioral healthcare is one strategy to improve access for these individuals.
This brief showcases how the plan’s integrated healthcare strategy has effectively reduced overdoses by 33%, self-harm incidence by 62% and NAS rates by 82% from July 2019 through April 2023 among Medicaid beneficiaries with OUD. Additionally highlighted is the plan's innovative approach to direct member services and successful partnerships to advance integrated care in West Virginia.
Related Public Policy Research
The opioid epidemic is projected to claim 1.2 million U.S. lives this decade without new efforts to stem the crisis. Policymakers can leverage COVID-19 pandemic era learnings, such as the use of telehealth, the continuation of cross-state licensure, and the employment of peers, to implement measures that support sustained access to evidence-based solutions for the delivery of care to individuals with OUD.
Coordinating Mental Health and Substance Use Disorder Services and Supports in Medicaid
Medicaid MCOs help states achieve whole person care by integrating services across physical healthcare, MH/SUD, and social supports, while promoting recovery and resiliency.
Early Findings from South Carolina’s Behavioral Health Integration
Positive outcomes of the MH/SUD “carve-in” included lower ER spending for behavioral health-related reasons, increased spending for certain prescription drugs, and quality improvements.
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