The Centers for Medicare and Medicaid (CMS) released a new guidance to State Medicaid Directors, opening the door to a larger pool of providers to offer care to beneficiaries and adding a new nurse advice line. As part of the guidance, a new group of behavioral health providers, including master’s level social workers, marriage and […]
Category: Medicaid
While private equity investors continue to look for new opportunities in behavioral health, there is one area that is still relatively uncharted: serious mental illness (SMI) care. Caring for the SMI population can be very challenging and requires a multipronged approach, as well as a robust patient engagement plan. Due to these challenges, SMI care […]
Behavioral health is at the heart of Elevance’s (NYSE:ELV) plans to increase its at-risk offerings. Specifically, Elevance plans to focus on rolling out its Medicaid behavioral health offering focused on serious mental illness care. “We have new offerings that are whole health full-risk opportunities, like assuming full-risk in oncology, as well as in Medicaid with […]
The Centers for Medicare & Medicaid Services (CMS) is working to improve access to behavioral health with a new initiative designed to integrate behavioral health with physical health. The newly launched program, called the Innovation in Behavioral Health (IBH) Model, will connect adults with mental health conditions or substance use disorders (SUDs) to physical, behavioral […]
The Centers for Medicare and Medicaid Services (CMS) has approved a $7.5 billion waiver for New York, allowing the state to integrate primary, behavioral health, and health-related social services over the next three years. One of the main goals of the waiver is to help boost population health and equity outcomes for high-risk Medicaid enrollees, […]
Access to and utilization of services was not better at integrated managed care organizations – Medicaid plans that do not carve out behavioral health services – compared to other models. That’s according to a new study published in JAMA, which analyzed claims-based measures of utilization, health-related outcomes, rates of arrests, employment and homelessness. Historically, Medicaid […]
Highmark Wholecare reports that over a third of its members have been diagnosed with at least one mental health condition. That’s according to a recent analysis of over 420,000 Highmark Wholecare members, which found that mental health disorders have become the most common health condition among its members, surpassing common conditions like diabetes, hypertension, tobacco […]
The state of New York fined five Medicaid managed care plans a total of $2.6 million for denying claims or failing to pay for specialty behavioral health services. Other states may start to follow New York’s example. The enforcements were filed after New York’s office of mental health conducted a comprehensive examination of behavioral health […]
Acadia Healthcare Co. Inc. (Nasdaq: ACHC) has plans to grow its partial hospitalization programs (PHP) and intensive outpatient programs (IOPs). Acadia’s preparations to weather the Medicaid redetermination storm have paid off and is now seeking to expand its continuum of care to meet increased needs and drive growth, according to its Q3 earnings call. The […]
State governors have named behavioral health as a top priority. This could give a boost to Centene Corp.’s (NYSE: CNC) behavioral health business and improve its business with state Medicaid programs. Behavioral health challenges for Medicaid enrollees have been a “top 3” issue conveyed by the “over 30 governors” with whom Ken Fasola, Centene’s president, […]
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