Medicaid reform: Integrating care creates healthier communities
The Daily Mining Gazette recently discussed a community health needs assessment report which highlighted the fact that all Upper Peninsula counties have multiple designations for health professional shortages, most notability in mental health services. Because of this, five percent of the population in the U.P. did not receive care for their behavioral health needs.
By contrast, according to a Regional Adult Health Survey, 25 percent of adults in the U.P. reported that they had been told by a health care provider that they had a depressive disorder and 20 percent of adults had a lifetime prevalent anxiety disorder.
Access to mental health supports is critical, especially for Michigan’s Medicaid population. Medicaid patients with mental health concerns often have physical health issues, but today their care is not coordinated like those of us with private insurance.
Legislation is being discussed in Lansing that would reform Medicaid to finally integrate physical and behavior healthcare and potentially expand access for mental health services for Michigan’s Medicaid population.
This concept has been talked about for nearly three decades and is long overdue. It will bring fairness and quality of care improvements to a current bifurcated model of care that isn’t serving the patients of the Upper Peninsula well today.
What compounds this this unmet demand for services is a broken and bifurcated system that treats Medicaid patients vastly different that those of us with commercial employer sponsored healthcare.
Medicaid patients do not have one health plan or public health system that oversees their physical and mental health. Michigan’s Medicaid program has overlapping layers made up of Pre-paid Inpatient Health Plans, Community Mental Health Service Providers, as well as Medicaid managed care Health Plans, all of whom treat different classes of patients with different networks for different physical or mental health needs. Patients must navigate both a public and private system of healthcare depending on their physical or behavior needs.
I have observed the ineffective and disjointed delivery of behavior health care for Medicaid patients in the U.P. for years. We need one system that can help those with both physical and mental health problems. A single network working in partnership with both physicians and mental health professionals can detect problems earlier and avoid more costly treatments.
Solving the provider shortage won’t be accomplished overnight, but demanding accountability from a single entity responsibility for improving collaboration among these overlapping layers to address the patients mental and physical health is a large step in the right direction. Thirty-three other states serve their Medicaid population under single network, it’s about time Michigan follow suit. Doing so puts patients first, improves their quality of care and creates healthier communities.
Dennis Smith is the president, Dennis H. Smith Consulting. He is also the former CEO of Upper Peninsula Health Plan.