Behavioral/Physical Health Integration: Twin Cities Flashback

Report to Congress highlighted the critical importance of Medicaid in the lives of so many low-income Americans. While the report focuses on Medicaid payments to safety-net hospitals and the future of children’s coverage, it was the chapter on integration of behavioral and physical health that particularly caught my eye.

It’s well documented that a disproportionately large number of Medicaid beneficiaries have a behavioral health diagnosis. The MACPAC report details the problems these beneficiaries encounter: siloed behavioral and physical health services lead to beneficiaries having multiple providers in multiple locations which, too often, results in declining health and soaring Medicaid costs. States are actively pursuing new programs to address these problems, but as MACPAC points out, the evidence base for this sort of integration is still in development.

As I read the chapter, I suddenly flashed back to a fascinating visit I made last year to the Coordinated Care Center at the Hennepin County Medical Center in Minneapolis. There, I had the privilege of sitting in on a team meeting made up of doctors, nurses, social workers, a psychologist and a substance use specialist. As the team reviewed its panel of high-need, high-cost patients, I was struck by the way the participants engaged in a conversation that flowed naturally among physical, behavioral and social issues. This holistic – and quite frankly, compassionate – approach has reduced both hospital admissions and unnecessary spending.

So, while MACPAC correctly notes that behavioral and physical health integration alone is not a panacea, our view at the Center for Consumer Engagement in Health Innovation is that continued investment in – and evaluation of – these approaches will move us toward a person-centered culture of care. Getting the details right and focusing on the whole person, as the good folks in Hennepin County are demonstrating, is the key.