Measuring Physical and Behavioral Health Integration: A Look at State Approaches in the Context of Value-Based Purchasing
The case for an integrated approach to care—one that can seamlessly and collaboratively address patients’ physical and behavioral health needs—is compelling. Individuals with behavioral health conditions, either a mental health diagnosis, a substance use disorder, or both, are some of the Medicaid’s most costly enrollees.[i] Analyses indicate this subset of high-cost enrollees typically has a complex combination of chronic physical and behavioral health conditions. Comprehensive and effective treatment for this population is challenging, due to siloed systems, access issues in behavioral health, and fee-for-service payment methodologies that do not support the integrated care of people with complex needs. Physical and behavioral health integration as a clinical approach presents an opportunity to promote quality, enhance access, and lower costs.[ii] Research indicates that integrated care management strategies such as health homes[iii] and evidence-based models such as Collaborative Care[iv],[v] can improve outcomes for people with complex, co-morbid physical and behavioral health conditions while potentially reducing costs.