New White Paper Series Looks at Emerging Best Practices Among
Medicaid Managed Care Organizations and States to Integrate Care for
Members with Mental Health Conditions or Substance Use Disorders
WASHINGTON--(BUSINESS WIRE)--Dec. 13, 2016--
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
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
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.
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Source: Anthem, Inc.