Integration of Medicaid Physical, Mental Health Does Not Aid Outcomes

MONDAY, Jan. 8, 2024 (HealthDay News) -- Financial integration of mental and physical health care at the managed care organization level is not associated with significant changes in most measures of utilization, quality, and outcomes, according to a study published online Dec. 28 in JAMA Health Forum.

K. John McConnell, Ph.D., from Oregon Health & Science University in Portland, and colleagues assessed the association of the transition to integrated managed care in Washington Medicaid with health services use, quality, health-related outcomes, and measures associated with social determinants of health. Analysis included about 1.45 million Medicaid enrollees in Washington State between 2014 and 2019.

The researchers found that financial integration was not associated with changes in claims-based measures of utilization and quality. While enrollees with mild or moderate mental illness experienced a slight decrease in cardiac events (−0.8 percent), most claims-based measures of outcomes were also unchanged. Enrollees with serious mental illness experienced small decreases in employment (−1.2 percent) and small increases in arrests (0.5 percent). Financial integration was perceived by key informants as an administrative change and did not have substantial implications for how practices delivered care. Behavioral health agencies reported lacking guidance on how to integrate care in behavioral health settings and struggled with new contracts and regulatory policies that may have inhibited the ability to provide integrated care.

"There was a hope that this would be a significant catalyst," McConnell said in a statement. "The idea was that integrating care within managed care organizations would drive positive changes at the clinical level, and that didn't really happen -- at least not yet."

One author disclosed personal fees from Omada Health.

Abstract/Full Text