Whole Person Care Improves Quality and Outcomes in Medicaid
States can improve outcomes for Medicaid beneficiaries by integrating physical healthcare benefits with mental health and substance use disorder (MH/SUD) services through comprehensive managed care organizations (MCOs). An IBM Watson Health study found that beneficiaries experienced increases in outpatient visits and improvements in medication management following integration.
Medicaid is one of the largest funding sources for MH/SUD treatment in the United States. While states take different approaches to provide these benefits, Medicaid programs are increasingly integrating MH/SUD services and physical healthcare benefits through MCOs rather than “carving out” MH/SUD services to a separate managed behavioral health organization (MBHO).
Although extensive research demonstrates the advantages of integrating physical healthcare benefits with MH/SUD services and supports generally, little research exists quantifying the impact of a carve-in (MCO) model versus a carve-out (MBHO) model. IBM Watson Health analyzed data from multiple states to assess the impact of integration over a two-year period following the move from a carve-out model to a fully carved-in model.
Related Public Policy Research
Community Health Worker Program Increased Access to Outpatient Care
Community Health Workers (CHWs), trusted laypeople who work or volunteer to improve health in their communities, have been shown to positively impact health outcomes when integrated into the healthcare system. By providing support from CHWs, an Elevance Health-affiliated Medicaid plan increased access to outpatient care for members with significant health-related needs.
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.