Integrating Health Care for High-Need Medicaid Beneficiaries With Serious Mental Illness and Chronic Physical Health Conditions at Managed Care, Provider, and Consumer Levels

Paper
Key Questions Answered
  • What’s an example of a promising program for care coordination for Medicaid beneficiaries with serious mental health illness (SMI)?
  • What were the outcomes of this program, and what lessons were learned?
Key Themes and Takeaways

This resource assesses HealthChoices HealthConnections, an integration pilot program for Medicaid beneficiaries with SMI and co-occurring chronic conditions in three Pennsylvania counties.

  • Better data is needed on the effectiveness of various types of care coordination strategies for Medicaid beneficiaries with SMI and chronic physical health conditions.
  • HealthChoices HealthConnections focused on consumer engagement and enhanced care coordination through the use of navigators—nurses, behavioral health clinicians, or case managers who helped consumers navigate the health care system, including education about appropriate emergency department (ED) use.
  • The number of ED visits among the intervention group decreased by 3.8%, but increased in comparison counties by 5.7%.
  • Findings demonstrate the value of nurse navigators (care managers) to bridge gaps between the physical and mental health care systems.
Authors
Jung Y. Kim
Tricia Collins Higgins
Dominick Esposito
Allison Hamblin
Population Addressed
People with Multiple Chronic Conditions
Level of Evidence
Strong
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