Medicaid Managed Care - U.S. Senate Special Committee on Aging

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Chapter 3
<strong>Medicaid</strong> <strong>Managed</strong> <strong>Care</strong> and Mental Healthl
Introduction
The Henry J. Kaiser Family Foundation and the federal Health <strong>Care</strong> Financing
Administration (HCFA), have launched a state symposia series, in which small
groups of state officials explore critical issues in building <strong>Medicaid</strong> managed care
programs. The second symposium, "Transitioning to <strong>Managed</strong> <strong>Care</strong>: <strong>Medicaid</strong>
<strong>Managed</strong> <strong>Care</strong> in Mental Health," was held April 24,1997 in Washington, D.C.
Nine states participated: Colorado, Connecticut, Delaware, Iowa, Massachusetts,
Oregon, Tennessee, Washington, and Wisconsin. They were selected due to their
diverse approaches to <strong>Medicaid</strong> managed mental health care. All currently enroll
<strong>Medicaid</strong> beneficiaries. (Note: This chapter does not provide a detailed explanation
of individual state approaches to managed mental health care but presents the
lessons these states have gleaned from their work. Appendix L provides a brief
description of each state's approach. Appendix M contains charts summarizing
these states' initiatives.)
The symposium and this paper limit discussion to mental health, not the full range
of behavioral health. This was done only as a means to organize complex
information and allow a substantive one-day discussion, about which this paper
reports.
Integrating Physical and Mental Health <strong>Care</strong>: To Carve Out or
Not to Carve Out?
System Design
States have developed a variety of approaches to <strong>Medicaid</strong> managed mental health
care, which continue to evolve as their experience grows. While no state approach
I This chapter is a shortened version of: Trish Riley, Joanne Rawlings-Sekunda, and
Cynthia Pemice, Transitioning to <strong>Managed</strong> <strong>Care</strong>: <strong>Medicaid</strong> <strong>Managed</strong> <strong>Care</strong> in Mental Heafth, (Portland, ME:
National Academy for State Health Policy, 1997). This publication is the second in The Kaiser-HCFA State
Symposia Series produced by the National Academy for State Health Policy under a contract with
Research Triangle Institute.
The National Academy for State Health Policy * 8/97
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