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Whole Person Care Improves Quality and Outcomes in Medicaid

March 2020
Full report

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.


  • Integrating MH/SUD in Medicaid managed care
  • Methodology
  • Changes in service utilization
  • Improvements in quality

Related Public Policy Research

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.

December 2020

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.

October 2019

Improving Psychotropic Medication Use Among Children in Foster Care

From 2014 through 2017, Amerigroup Georgia lowered the number of prescriptions filled per 1,000 children by 3 percent for all psychotropic medications and by 8 percent for antipsychotics.

July 2019