WASHINGTON--(EON: Enhanced Online News)--One in five Medicaid beneficiaries has a mental health condition and/or substance disorder, and 60 percent of those individuals also have chronic physical health conditions -- which makes connecting those members to social support services critical to improving their wellbeing, according to a new white paper from Anthem’s Public Policy Institute.
“MCOs are uniquely positioned to support the delivery of integrated, holistic care. MCOs can serve as the locus of coordinated care for beneficiaries by working with state Medicaid programs, mental health agencies, providers, members and their families, as well as community-based organizations that coordinate housing and other needs.”
Medicaid managed care organizations (MCOs) are partnering with state and federal policymakers to offer a range of options for fully integrating physical health, mental health/substance use disorder and pharmacy benefits along with critical connections to social supports such as housing and employment. The Anthem Public Policy Institute paper examines how MCOs are venturing outside of the clinical domain to build strong partnerships with community-based organizations. It also highlights how MCOs are developing more sophisticated tools and strategies for connecting members with these resources.
“Too often, owing to the typically siloed nature of health care services and payment for physical health and mental health/substance abuse treatment, these conditions have been treated apart from one another, leading to poorer outcomes and higher costs,” said Jennifer Kowalski, vice president of the Anthem Public Policy Institute. “MCOs are uniquely positioned to support the delivery of integrated, holistic care. MCOs can serve as the locus of coordinated care for beneficiaries by working with state Medicaid programs, mental health agencies, providers, members and their families, as well as community-based organizations that coordinate housing and other needs.”
Along with the white paper examining MCOs’ role in connecting members with social supports, the series of papers from the Anthem Public Policy Institute highlights several additional areas for consideration in improving health outcomes for Medicaid members with mental health conditions and/or substance use disorders:
- Development of Medicaid MCO programs that fully integrate physical and mental health and/or substance use disorder care for members at the point of care delivery and incentivize MCOs to integrate health care operations, analytics and care coordination to better support members.
- Adoption of value-based care models aimed at improving the quality of care and outcomes for individuals with mental health conditions and/or substance use disorders by focusing on the delivery of high-quality, holistic, and integrated care and services.
- Methods to address the regulatory and legal landscape governing the exchange of sensitive patient information among physical health, mental health and substance use disorder providers, and strategies being employed by MCOs to improve information sharing and protect patient privacy.
The Anthem Public Policy Institute prepared these white papers with assistance from consulting firms Manatt Health and CapView Strategies. Manatt and the Anthem Public Policy Institute hosted a webinar on December 7 to discuss how MCOs, working in partnership with states, are connecting members with mental health conditions and/or substance use disorders to critical social supports; click here to access a recording of the event. Copies of the Anthem Public Policy Institute’s white papers are available at: http://anthempublicpolicyinstitute.com, and are also discussed at: http://thinkanthem.com.
About the Anthem Public Policy Institute
The Anthem Public Policy Institute was established to share data and insights to inform public policy and shape the health care programs of the future. The Public Policy Institute strives to be an objective and credible contributor to health care innovation and transformation through publication of policy-relevant data analysis, timely research and insights from Anthem’s innovative programs.
About Anthem, Inc.
Anthem is working to transform health care with trusted and caring solutions. Our health plan companies deliver quality products and services that give their members access to the care they need. With over 73 million people served by its affiliated companies, including nearly 40 million within its family of health plans, Anthem is one of the nation’s leading health benefits companies. For more information about Anthem’s family of companies, please visit www.antheminc.com/companies.