|Year of Publication||2008|
|Authors||National Association of State Medicaid Directors|
|Selection||Financing & Sustainability; Grey literature;|
A recent trend in behavioral health care has been the increasing integration ofbehavioral health services into primary care settings. This paper discusses the benefits of such integration and the role of safety net primary care providers as behavioral health providers within the Medicaid program. The Health Resources and Services Administration (HRSA) is a grant funding source for safety net providers and programs, and has encouraged FQHCS, Ryan White HIV/AIDS program organizations, maternal and child health clinics, and Rural Health providers, to develop and implement dynamic behavioral health initiatives as Medicaid providers. As demonstrated in the following four state initiatives, state Medicaid agencies are pursuing a range of approaches for the integration of behavioral health services in primary care settings fostering positive working relationships between primary care safety net providers and the specialty mental health sector for the benefit of Medicaid enrollees. Two fundamental characteristics of these approaches are the organizational structure and the reimbursement model for behavioral health services. Each of these characteristics is discussed within the context of various state programs. This paper does not attempt to speak to the totality of issues that should be addressed in the discussion of integrated behavioral health care services. Other important issues of concern include: maintaining patient continuity of care when a state carves out behavioral health services within a Medicaid Managed Care Organization contract; training primary care providers to better recognize clinical signs of a mood disorder for prompt referral to behavioral health treatment, and finally, the impact of reimbursement rates on provider availability and timely access to necessary services. These issues have a tremendous cumulative impact on the effectiveness of mental health service delivery in America and largely remain unresolved. The state programs examined here have all used various approaches to ameliorate these systemic concerns, but no one solution has yet emerged.
|Additional||More about this reference (PDF - 0.16 MB)|
|Note||This grey literature reference is included in the Academy's Literature Collection in keeping with our mission to gather all sources of information on integration. Grey literature is comprised of materials that are not made available through traditional publishing avenues. Often, the information from unpublished resources can be limited and the risk of bias cannot be determined.|