The National Association of State Mental Health Program Directors has released a presentation examining care integrationg efforts for individuals with serious mental illnesses (SMIs) in Missouri.  The presentation outlines the state's activities under the initiative and highlights care integration and cost savings achieved as a result of those efforts.  The authors assert that Missouri serves as a model for other states to follow.

From the report:

The webinar focused on Missouri’s initiative to integrate behavioral health and primary care, including the state’s application for a health home state plan amendment under Section 2703 of the Affordable Care Act.  Dr. Joe Parks, with Missouri’s Department of Mental Health, gave an overview of the state’s health home initiative highlighting their definition of health homes, services implemented, outcomes achieved such as cost savings, and recommendations for integrating health care. 

Full report: Missouri’s Efforts to Integrate Care for Individuals with Serious Mental Illness: A Catalyst for Other States (PDF | 10.61 MB)

National Association of State Mental Health Program Directors.  (2011).  Missouri's efforts to integrate care for individuals with serious mental illness: a catalyst for other states.  Parks, J.

Health Affairs has published a study examining 17 states' patient-centered medical home initiatives.  The authors suggest that early findings indicate that the programs have been generally successful, resulting in improve care quality and cost trends.  The report also asserts that the initiatives have improved access to health services. 

Takach, M.  (2011).  Reinventing Medicaid: state innovations to qualify and pay for patient-centered medical homes show promising results.  Health Affairs, 30 (7): 1325-1334.  doi: 10.1377/hlthaff.2011.0170.  http://content.healthaffairs.org/content/30/7/1325.abstract

Author: Mary Takach

The Center for Health Care Strategies, Inc. has released a brief examining opportunities to establish effective accountable care organizations (ACOs) in Medicaid.  Outlined under the national health care reform law, the brief notes that ACOs can improve care coordination to reduce costs through combined medical, behavioral health, and social service offerings.

From the report:

Across the country, health purchasers are exploring the potential of accountable care organizations (ACO) to provide higher quality and more efficient care. Progress is being made for Medicare and commercial populations: the Brookings-Dartmouth ACO Pilot1 is developing commercial shared savings contracts with private payers; the Centers for Medicare & Medicaid Services (CMS) released a proposed rule for a Medicare Shared Savings Program;2 and the Center for Medicare and Medicaid Innovation is supporting a Pioneer ACO Model for Medicare and multi-payer ACOs.  Yet, while much of the national ACO focus has been on Medicare and commercially insured populations, these new models also offer a critical opportunity to improve care and control costs for Medicaid programs. A community-focused, integrated model of care provides significant potential for improving care coordination and reallocating health care dollars more effectively for millions in the nation’s health care safety net. As Medicaid prepares to expand coverage to an additional 16 to 20 million Americans in 2014, the program must also rethink how it delivers primary and chronic care, particularly for its highest-need, highest-cost patients. Medicaid can use its tremendous purchasing power to drive delivery system redesign and payment reform through ACOs.

Full report: Accountable Care Organizations: Creating a Workable Approach for Medicaid (PDF | 62 KB)

Center for Health Care Strategies, Inc.  (2011).  Accountable care organizations: creating a workable approach for Medicaid.  Highsmith, N. and McGinnis, T.

The Center for Health Care Strategies, Inc. has released a brief examining the establishment of physician-supported entities (PSEs) in Medicaid.  The authors note that PSEs can help providers improve service delivery through improved quality and efficiency.  The brief offers strategies for Medicaid agencies to facilitate the development of PSEs.

From the report:

Physician-support entities (PSEs) offer an emerging opportunity to enhance the capabilities of evolving physician networks. PSEs can be based on physician, health plan or community organizations that form to provide quality improvement, performance measurement, health information technology, care management, and leadership support to practices. PSEs can also be building blocks to help establish more organized Accountable Care Organizations.

Full report: Creating Physician-Support Entities in Medicaid (PDF | 84 KB)

Center for Health Care Strategies, Inc.  (2011).  Creating physician-supported entities in Medicaid.  Highsmith, N.

The Center for Health Care Strategies, Inc. has published a brief on implementing health homes in risk-based Medicaid managed care systems.  The authors examine how states can advance health home programming within existing risk-based Medicaid managed care systems.

From the report:

Health homes present a significant opportunity for Medicaid programs to change the way care is delivered to some of the
most vulnerable Americans and to curb growing health care costs. Likewise, they also present a transition for MCOs − specifically, an opportunity for them to redefine their role and confirm their value. Innovative and forward-thinking MCOs will recognize and seize the opportunity to position themselves for the future, differentiate themselves from their peers and change care management as we know it.

Full report: Implementing Health Homes in a Risk-Based Medicaid Managed Care Delivery System (PDF | 275.39 KB)

Center for Health Care Strategies, Inc.  (2011).  Implementing health homes in a risk-based Medicaid managed care delivery system.  Hasselman, D. and Bachrach, D.

The Center for Health Care Strategies, Inc. has released a brief examining important issues in the development of Medicaid health homes.  The authors note that the national health care reform law presents opportunities to establish health homes serving individuals with chronic illnesses and/or severe mental illnesses.  Drawing on a stakeholder panel, the brief offers considerations for states in the preliminary stages of planning health homes.

From the report:

The Affordable Care Act of 2010 (ACA) presents a new opportunity for Medicaid programs to develop health homes for patients with multiple chronic conditions and/or severe mental illness. Through health homes, Medicaid can reimburse for critical services: comprehensive care management; care coordination and health promotion; transitional care; individual and family support; and referrals to community and social support services. States will be eligible to receive 90/10 federal matching funds for two years, thus creating a tremendous opportunity to demonstrate how coordinated care management can improve quality and potentially bend cost trends.

Full report: Initial Considerations to Guide the Development of Medicaid Health Homes (PDF | 79.33 KB)

Center for Health Care Strategies, Inc.  (2011).  Initial considerations to guide the development of Medicaid health homes.  McGinnis, T.