Many states are developing and implementing strategies for integrating behavioral health with primary care. Integrated care improves patients’ access to behavioral health services, attendance at scheduled appointments, satisfaction with care, and adherence to treatment. Minority populations in particular are more likely to seek mental health treatment from primary care practitioners than from mental health specialists. Medicaid payment policies, including reimbursement for behavioral health screenings, management, and referrals in primary care settings, can facilitate this integration.
This brief examines key elements of the seven state SCHIP buy-in programs in operation in 2005. The buy-in programs are designed to fill a coverage gap created when children leave the SCHIP program due to loss of financial eligibility and then become uninsured because their families do not have access to employer coverage or cannot afford private coverage.
This report briefly reviews findings from the health services research literature on issues related to charging premiums for public health coverage programs. Findings from an October 2002 survey of the 41 current Medicaid buy-in programs operated by 29 states also are presented. Finally, a discussion of the implications of the research findings from the perspectives of the state officials attending the expert meeting is presented. The group addressed practical and policy issues related to charging premiums for Medicaid and, more broadly, some topics pertinent to redesigning Medicaid.