Physical and mental illness and substance abuse often arrive hand in hand. They are starting to be treated that way too.
A disproportionate number of Medicaid’s highest-cost members deal with multiple chronic health conditions in addition to mental illness, according to a 2009 study by the Center for Health Care Strategies.
There is a growing consensus among state Medicaid programs that physical, behavioral and substance use services should be integrated. This helps better serve members and keep health care costs in check.
The Affordable Care Act of 2010 lets states establish Medicaid-financed Health Homes. These are not places but sets of services that help coordinate care. The services are for members who have chronic conditions like asthma and diabetes in combination with persistent mental health issues.
Health Homes provide integrated care by:
- Coordinating treatments across different settings, providers and community resources.
- Helping patients self-manage their illnesses and make health decisions.
- Using clinical information systems to manage care and monitor outcomes.
States have implemented integrated treatment options in various ways, including the following.
California: San Diego County and Optum® have worked to integrate care between the behavioral health provider network and health centers where many members receive medical care.
Idaho: In collaboration with the state, Optum aims to transform the outpatient mental health and substance use system to help people reach recovery. To create a more coordinated and accountable behavioral health system, Optum is expanding the local network of behavioral health providers and offering new services.
- Peer support programs.
- Services that help enrollees transition smoothly back to living in their communities following discharge from a hospital or other in-patient facility
- Programs that support enrollees’ family members.
Washington: Optum and Pierce County transformed the region’s crisis system into a community-based, recovery-oriented response system integrating peer supports and a no-force approach to care.
By connecting people with mental health conditions to appropriate resources, unnecessary hospitalizations declined by more than 32 percent. Enrollees’ physical and mental health is monitored and cared for through a network of inpatient, outpatient and residential treatment providers, specialized mobile crisis teams and certified peer counselors.
In light of their constrained budgets, many Medicaid programs are working to further integrate services to improve access and lower costs. Optum is committed to working in partnership with public entities to implement accountable, outcome-driven results that help Medicaid programs make the most effective use of public funding.
Learn more about Optum Medicaid Health Services, which is focused on integrated care, wellness and prevention.