Integration of behavioral and physical health care for a medicaid population through a public-public partnership.
This article documents a unique organizational, legal, and financial partnership between a state, a university, a Medicaid managed health care plan, and a county to provide integrated mental health, substance abuse, and primary and specialty health care services to Medicaid, low-income, and indigent consumers in Washtenaw county, Michigan. Major regulatory, financial, and clinical changes were required within and among the various partners in the Washtenaw County Integrated Health Care Project. A new entity--the Washtenaw Community Health Organization--was created to implement the project. By sharing resources as well as financial risks, the state, the county, and the university have been able to provide ongoing integrated care to a vulnerable population of patients. Although resource intensive in conceptualization and implementation, the project can be viewed as a model for other states that face growing needy populations and decreasing Medicaid budgets.
Grazier
Kyle L
KL
Department of Health Management and Policy, University of Michigan School of Public Health, 109 South Observatory, Ann Arbor, MI 48109-2029, USA. kgrazier@umich.edu
Hegedus
Andrea M
AM
Carli
Thomas
T
Neal
David
D
Reynolds
Kathleen
K
D000046:Academic Medical Centers / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration; D003131:Combined Modality Therapy; D015897:Comorbidity; D019033:Delivery of Health Care, Integrated / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D006801:Humans; D009111:Local Government; D008329:Managed Care Programs / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D008484:Medicaid / Q000191:economics / Q000331:legislation & jurisprudence*; D001523:Mental Disorders / Q000191:economics / Q000534:rehabilitation*; D008824:Michigan; D010348:Patient Care Team / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration; D011320:Primary Health Care / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D017150:Public Sector / Q000191:economics / Q000331:legislation & jurisprudence / Q000458:organization & administration*; D013221:State Health Plans / Q000191:economics / Q000331:legislation & jurisprudence; D019966:Substance-Related Disorders / Q000191:economics / Q000534:rehabilitation*; D017664:Uncompensated Care / Q000191:economics / Q000331:legislation & jurisprudence*; D014481:United States