Integration of Physical and Behavioral Health in Medicaid Managed Care
It is critical to address the fragmentation in the delivery of physical healthcare and treatment of mental health conditions and/or substance use disorders. In Medicaid, managed care organizations (MCOs) are leading integration efforts in partnership with states to improve outcomes and reduce costs.
One in five Medicaid beneficiaries has a mental health condition and/or substance use disorder and 60 percent of those individuals also have chronic physical health conditions. But owing to the siloed delivery and payment of physical health, mental health, and substance use disorder services, Medicaid beneficiaries too often receive uncoordinated care, leading to poorer health outcomes and higher costs.
States are experimenting with a range of integration approaches in partnership with MCOs. While many efforts are still in their early stages—and the impact of these efforts is not yet known — analyses of longer standing Medicaid managed care programs demonstrate program savings and improved health outcomes.
Related Public Policy Research
Connecting Medicaid Beneficiaries to Social Supports for Mental Health and Substance Use Disorders
MCOs partner with states to facilitate access to supports and address gaps in housing, job training, and other drivers that affect the health and wellbeing of beneficiaries with MH/SUD.
Strategies for Effective Sharing of Behavioral Health Information in Medicaid Managed Care
Sharing patient data between physical health and mental health and/or substance use providers is necessary for integration of care, but is often hindered by complex laws and regulations.
Value-Based Care Models for Mental Health and Substance Use Services in Medicaid
Medicaid MCOs are increasingly adopting value-based care models that incentivize an integrated approach to the identification and treatment of MH/SUD, along with physical health conditions.