Mixed results from great study on Medicaid behavioral health interventions

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Yesterday’s MAPOC Complex Care Committee meeting focused on results of an adult high behavioral health need member initiative by Beacon, Medicaid’s behavioral health administrator. The program serves high utilizers of hospital services with behavioral health needs providing intensive care management by teams of clinicians and peer specialists. Medicaid members with high behavioral health needs were more likely to be men between the ages of 45 and 54, and have three or four “high burden”, complex diseases than the rest of the Medicaid program. But interestingly, they were less likely to be Black or Hispanic. Compared to a matched control group that did not receive the intervention, Beacon expected the intervention group (people served at six high volume CT hospitals) who got the intensive team care coordination would have lower use of hospital services, fewer readmissions, better follow up care, improved behavioral health status, and costs of care would shift from hospitals to the community. But what they found was mixed – hospital use declined in both groups about equally, better connection to follow up care for the intervention group, but the total costs of care were lower in the control group. The committee discussed possible reasons that the intervention wasn’t entirely successful including not waiting long enough to see the impact, choosing members whose needs had grown very serious over time, and regretfully, the possibility that the intervention just doesn’t work. As no members were dropped from the program, it is likely that the state sent savings to that were earned by this program to PCMH + ACOs. The committee offered lots of ideas for improvements. We will continue to track progress and congratulated Beacon on their foresight to measure progress in a rigorous study, to honestly share the results, both successes and disappointments, and act on them to improve care for CT Medicaid members.