Medicaid Integration

Presentations from the 2014 National Home and Community Based Services (HCBS) Conference.

Presentations from the 2015 National Home and Community Based Services (HCBS) Conference.

Presentations from the 2016 National Home and Community Based Services (HCBS) Conference.

While faced with new challenges, reduced budgets, and growing populations requiring more services, states are stronger than ever, and the work they do is more effective than ever in reaching individuals and addressing their needs. The National Home and Community Based Services (HCBS) Conference 2017 highlights these achievements, allowing states to share best practices, present unique partnerships, and recognize the work of their peers.

University Center for Children and Families (CCF) and the University of North Carolina NC Rural Health Research Program (NC RHRP) studies the effects of Medicaid on rural areas and small towns as opposed to dense metropolitan areas. Since the implementation of the ACA, those who are covered by insurance have noticeably increased the number of Americans who are insured.

The Milbank Memorial Fund released a new study, the Role of State Medicaid Directors: A Leadership Imperative. This study was authored by Andy Allison, a former Kansas and Arkansas Medicaid Director. The study focuses on the current climate of Medicaid policy, organizations and leadership. There is a specific focus on how the administration is structured for Medicaid in the states and the adequacy of state investments in the role and compensation of these leaders.

The AARP Public Policy Institute released a new report conducted by Truven Health Analytics. The two part study examined Medicaid Managed Long Term Services and Supports program contracts in 18 different states for older adults and people with physical disabilities and case studies of new care coordination models in Ohio and Illinois. The findings indicate that states need care coordination and that these care coordinators provide crucial support for consumers and their family caregivers.

The second annual report to Congress examines the services utilized by Medicaid's behavioral health beneficiaries. The findings indicate that low-income children have high levels of unmet need in the mental health care arena. Additionally, the review of Medicaid's dental coverage found considerable variation between states, particularly for services provided to adults. The report findings illustrate the potential directions for change to improve care for beneficiaries.

Better integration of physical and behavioral health is a critical component of improving outcomes and reducing costs for Medicaid beneficiaries, especially those with high levels of need. This report profiles four examples where the safety net community – health plans, community health centers, community mental health centers, and the centers’ primary care and behavioral health clinicians – have collaborated to develop programs to integrate care for this population.

This report describes the different strategies that four states are utilizing to improve the integration and coordination of care for individuals with mental health and substance use disorders. These strategies include introducing new managed care arrangements and care coordination mechanisms, enhanced payment to providers to deliver comprehensive services, and the full integration of physical and behavioral health services in managed care contracts.