5123.0: Wednesday, November 15, 2000 - 1:25 PM

Abstract #11925

Integration of healthcare under Medicaid managed care

Andrea M. Hegedus, PhD1, Kyle L. Grazier, PhD2, Thomas Carli, MD1, and Kathy Reynolds3. (1) Department of Psychiatry, University of Michigan, 400 E. Eisenhower Parkway, Suite 2A, Ann Arbor, MI 48108, (734) 998-7952, hegedus@umich.edu, (2) School of Public Health, University of Michigan, (3) Washtenaw County Community Mental Health

Individuals who receive alcohol treatment and healthcare from publicly funded programs such as Medicaid often receive compromised care. Because they are often difficult to treat, multiple agencies are responsible for different aspects of their care, and there is little continuity or oversight given to their care. The addition of managed care to this scenario adds yet another area of complexity. To address these issues, the University of Michigan, Washtenaw County, and the State of Michigan have entered into a unique partnership to provide managed healthcare to Medicaid recipients. The project integrates substance abuse (SA), mental health (MH), and primary care (PC) services through the creation of a new managed care entity, created under the legal authority and sponsorship of the State, County, and University. This natural experiment provides a unique opportunity to understand how the organization and financing of services impact on the availability, quantity, and quality of services delivered to an often under-served population. As managed care expands to cover behavioral health care and as public systems like Medicaid embrace managed care, understanding the role of integration of services on access, delivery, and payment is crucial. This presentation will be comprised of an organizational analysis that will focus on the development and initiation of this unique partnership, description of the financial arrangements and risk sharing, and an account of the changes in the delivery system.

Learning Objectives: At the conclusion of this session, participants will understand the role of integration of services on access, delivery, and payment; be able to describe the steps in the development and initiation of provider partnerships; have an understanding of issues related to financial arrangements and risk sharing; and be able to identify subsequent changes in the delivery system

Keywords: Community-Based Partnership, Managed Care

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA