Managed care plans say access to data continues to be a major barrier to behavioral and physical health integration

ID 97366080 © Bialasiewicz | Dreamstime.com

6ab2bc1226d361f9e2eb4fa5 Dreamstime Xl 97366080

Eighty percent of Medicaid managed care organizations participating in the Institute for Medicaid Innovation’s annual Medicaid MCO survey reported barriers related to workforce, data sharing, care integration, and persistent stigma when supporting the needs of those enrolled in the Medicaid program. 

In its ninth year, IMI’s annual survey is intended to equip Medicaid stakeholders with the information needed to accurately articulate the national narrative about Medicaid managed care.

The survey findings found that behavioral health workforce capacity remains a key challenge to behavioral health service access in Medicaid; even as telehealth becomes less of a barrier:
• 91% of health plans identified the need for Medicaid agencies to facilitate greater participation in the Medicaid program on the part of behavioral health clinicians, while also facilitating initiatives to grow the behavioral health workforce.
• 77% of health plans identified cover codes for mental health screening, peer support, and collaborative care as a key opportunity for state Medicaid agencies to lean in.
• 68% of health plans reported that state Medicaid agencies have an opportunity to support the behavioral health home model, as well as community-based service providers.

The survey also found that barriers to integration of behavioral and physical health are multi-faceted and include operational, network, and policy opportunities for improvement:
• 64% of health plans cited fragmentation in funding and contracting as a policy barrier to integration.
• Access to data continued to be a major barrier to behavioral and physical health integration for 45% of participating health plans.
• Over 70% of health plans cited limited capacity to integrate at the point of care as a barrier.
• 77% of participating health plans reported challenges accessing data from other network entities, including departments of health and substance use programs.

IMI notes that the  findings highlight that successful integration of behavioral health requires technology enhancements, stronger data sharing practices, improved partnerships among organizations, and access to timely information across the continuum of care.

Most of the participating health plans reported experiencing multiple barriers when providing and managing behavioral health services for children and adolescents, including cultural and family stigma around mental illness (73%), and availability of in-person behavioral health providers (68%).

Health plans reported the following initiatives and efforts to address these and other barriers:
• 77% of participating health plans reported that they are educating members to help reduce stigma around mental illness.
• 64% are improving access to behavioral health services for children and adolescents by contracting with more virtual behavioral health providers.
• 55% administered behavioral health services in schools.
• 46% provided coaches and peer support to expand available resources.

About the Author

David Raths

David Raths

David Raths is a Contributing Senior Editor for Healthcare Innovation, focusing on clinical informatics, learning health systems and value-based care transformation. He has been interviewing health system CIOs and CMIOs since 2006.

 Follow him on Twitter @DavidRaths

Sign up for our eNewsletters

Get the latest news and updates