Everyone agrees on integrated care. No one agrees on who pays for it

This article was originally published at Everyone agrees on integrated care. No one agrees on who pays for it.

Leaders across behavioral health agree that integrating mental health and substance use care with physical health care produces better outcomes and lower costs. The unresolved question, raised at this week’s Association for Behavioral Health and Wellness conference, is who pays for the integration.

A 2021 study in Medical Care found that collaborative care generated roughly $1.70 in savings for every dollar spent on implementation. But those savings accrue mostly to physical health payers, not to the behavioral health providers who bear the cost of building integrated teams.

“Fee-for-service models aren’t it,” said Chuck Ingoglia, president and CEO of the National Council for Mental Wellbeing. “We probably need more capitated, integrated funding streams.” Health homes, he added, need “explicit, integrated, longitudinal funding,” and the data has to flow so that organizations can make smart decisions about deploying resources.

Dr. Caroline Carney, CEO of Magellan Health, argued that Medicaid health plans must pay for behavioral health integration and run on collaborative care codes. Arthur Evans, CEO of the American Psychological Association, noted that because benefits accrue to the physical health side, the field needs alternative payment models that reward integrated practice.

The stakes are rising: as Medicaid redeterminations reshape enrollment, the share of members with concurrent behavioral health needs is expected to climb from 36 percent to as much as 48 to 52 percent.

This article was originally published at Everyone agrees on integrated care. No one agrees on who pays for it.