Integrating physical and behavioral healthcare in Medicaid managed care did not result in significant changes in utilization, outcomes or social determinants of health, a study published Dec. 28 in JAMA Health Forum found.
The study, written by researchers at Oregon Health and Science University in Portland, examined outcomes for 1.5 million Medicaid beneficiaries in Washington state between 2014 and 2019, during its transition to integrated behavioral and medical care. The researchers also interviewed behavioral health agency leaders, managed care administrators and individuals participating in the transition.
John McConnell, PhD, director of Oregon Health and Science University's Center for Health Systems Effectiveness and the lead author of the study, said there was hope integrating mental and physical care into the same Medicaid contract would be a "significant catalyst" for improved outcomes.
"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," Dr. McConnell said in a Dec. 28 news release.
Though the program did not result in significant changes, it also did not worsen outcomes, Dr. McConnell said.
The number of states carving out behavioral health into separate Medicaid contracts has declined from 20 in 2004 to six in 2019, according to the study.
Integrated care in Washington state did not lead to any change in the rates of mental health visits among Medicaid beneficiaries with mild, moderate or severe mental illness. Among enrollees with severe mental illness, employment decreased by 0.9 % when enrollees received integrated care, and arrests increased by 0.5 %.
See the full study here.