State Strategies for Improving Provider Collaboration and Care Coordination for Medicaid Beneficiaries with Behavioral Health Conditions
ASPE Issue Brief
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Associated Project
Innovative State Systems Supporting Coordinated Services for Individuals with Mental and Substance Abuse Disorders
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
Key Findings
Key Findings:
- Although new financing mechanisms and managed care arrangements are intended to facilitate care coordination while taking advantage of existing Medicaid benefits, on-the-ground care coordination and the nurturing of provider collaborations have been essential to connect individuals to services.
- State officials, managed care representatives, and providers alike in all four states stressed almost universally the importance of reimbursement for case management or care coordination services.
- Providers in several states mentioned that evidence-based practices or approaches to team-based care coordination sometimes do not align with standard billing codes or managed care approaches to reimbursement.
- Providers and state officials noted the importance of thoughtfully engineered and executed billing processes and policies.
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 (see Table 1 for a summary of state strategies). It 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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