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State Strategies for Coordinating Medicaid Services and Housing for Adults with Behavioral Health Conditions
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State Strategies for Coordinating Medicaid Services and Housing for Adults with Behavioral Health Conditions

ASPE Issue Brief
Published: Apr 30, 2015
Publisher: Washington, DC: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, Office of Disability, Aging, and Long-Term Care Policy
Health Delivery System Reforms Disability Mental Health and Substance Use Long-Term Services and Supports Medicaid and CHIP Research & Evaluation Policy Analysis

Associated Project

Innovative State Systems Supporting Coordinated Services for Individuals with Mental and Substance Abuse Disorders

Time frame: 2013-2014

Prepared for:

U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation

Office of Disability, Aging, and Long-Term Care Policy

Authors

Rebecca Kleinman

Matthew Kehn

Allison Wishon Siegwarth

Jonathan Brown

Key Findings

Key Findings:

  • States are encouraging managed care plans to focus on the coordination of behavioral health and housing services. Three of the states in this study have required or allowed their Medicaid managed care plans to develop and reimburse care coordination strategies that focus on beneficiaries with housing needs. Three of the states are using waivers and/or State Plan Amendments to authorize enrollment of Medicaid beneficiaries in managed care and to provide services for people in supportive housing.
  • States and managed care entities have created reimbursement mechanisms that facilitate care coordination. Ensuring that people who are homeless or unstably housed receive services to maintain their housing requires intensive human interactions, including those that take place in person and in the community. Representatives from the four states in this study emphasized that these high-need individuals require a commitment of time and resources from dedicated staff.
  • State initiatives are fostering local partnerships between providers. Several providers, health plans, and state officials reported that local partnerships were key to the success of their efforts. Each state implemented financing mechanisms at the state level to facilitate and encourage collaborations among local providers. Such collaborations are particularly helpful in identifying limited housing resources, because Medicaid only covers physical and behavioral health services.

This issue brief highlights the efforts of four states—Illinois, Louisiana, Massachusetts, and Tennessee—to facilitate provider-level coordination for Medicaid beneficiaries with behavioral health disorders. It describes the financing strategies and specific mechanisms that states are using to improve care coordination and summarizes some of the key ingredients of these efforts as reported by providers, consumers, agency representatives, and managed care companies in the four states.

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