Value-Based Care Models for Mental Health and Substance Use Services in Medicaid
Increasingly, Medicaid managed care organizations (MCOs) are adopting value-based care models to improve care for individuals with mental health conditions and/or substance use disorders. These models incentivize an integrated approach to the identification, treatment, and management of mental health and substance use disorders, along with physical health conditions.
Individuals with mental health and/or substance use disorders have typically received care in a fragmented delivery system that rewards providers for volume rather than value of care. Value-based models promote a holistic approach by incentivizing mental health and substance use providers to address physical health needs and encouraging primary care providers to screen, manage, and refer patients with mental health and/or substance use disorders.
The use of value-based models for mental health and substance use treatment is relatively new but holds significant promise. Medicaid MCOs are working with providers on care coordination, data analytics, and performance measurement and improvement to accelerate the adoption of value-based care.
Related Public Policy Research
Integration of Physical and Behavioral Health in Medicaid Managed Care
MCOs are partnering with states to address the fragmentation in the delivery of physical healthcare and MH/SUD services, in order to improve outcomes for beneficiaries and control costs.
Connecting Medicaid Beneficiaries to Social Supports for Mental Health and Substance Use Disorders
MCOs partner with states to facilitate access to supports and address gaps in housing, job training, and other drivers that affect the health and wellbeing of beneficiaries with MH/SUD.
Strategies for Effective Sharing of Behavioral Health Information in Medicaid Managed Care
Sharing patient data between physical health and mental health and/or substance use providers is necessary for integration of care, but is often hindered by complex laws and regulations.