Center for Health Care Strategies

In recent years, state Medicaid agencies have started to integrate mental health and substance use disorder services into existing managed care programs. Referred to as carving-in behavioral health, or integrated managed care, this approach seeks to better coordinate care delivery for people with physical and behavioral health needs. Carving-in behavioral health care can improve the quality and experience of care for patients, enhance care coordination and data-sharing among providers, and promote greater cost predictability for states. This Better Care Playbook Evidence Roundup offers insight into the evidence base on carving-in behavioral health care into managed care and considerations for states interested in implementing this approach. https://bit.ly/4ebut7s

In our October 2024 Monthly Update, we focus on addressing access to mental health and substance use disorder care during pregnancy and postpartum, explore opportunities to advance social needs screening policies and programs, welcome the newest class of the Medicaid Pathways Program, and much more!

This week, we were honored to host the Medicaid and Corrections Policy Academy in-person convening alongside the Center for Health Care Strategies, on behalf of the OJP Bureau of Justice Assistance. Teams from Alaska, Colorado, Maine, North Carolina, Oklahoma, and Wisconsin united in Washington, DC, with a shared commitment to improving health outcomes for people with complex needs navigating reentry. Special thanks to our federal partners and experts from mentor states Arizona, Montana, and New Hampshire for their ongoing dedication to this critical work.

How can states use data to better understand the prevalence of adverse childhood experiences (ACEs) and positive childhood experiences (PCEs) in their states? New Jersey, like many states, is developing a statewide infrastructure for collecting data on ACEs and PCEs. This profile shares how New Jersey, with support from Centers for Disease Control and Prevention, is working to better understand the impact of ACEs and PCEs across the state through data, with the goal of designing initiatives that promote child health and well-being. https://bit.ly/3C4HIcC Jordan Carl, MPH, Elizabeth Buck, Aaron Truchil; Tyler Yost, Camden Coalition, J. J. Cutuli, Nemours

Congratulations to 20 rising Medicaid agency leaders competitively selected for the 2025 class of the Medicaid Pathways Program! This executive training initiative, led by the Center for Health Care Strategies with support from the Robert Wood Johnson Foundation (RWJF), is a unique opportunity to build the leadership and policy skills of the next generation of senior Medicaid staff. Since 2021, the Medicaid Pathways Program has supported 80 new Medicaid leaders from 31 states, the District of Columbia, and Puerto Rico — supporting a pipeline of future Medicaid executives with varied backgrounds, perspectives, and lived experience. Ensy Atarod; Alanna Dancis; Benjamin Ebeigbe; Emily Eibl; Katie Evans; Gene Hermanson; Oksana Hill; Ann Jensen; David Jorgenson; @Eve Lickers; Samantha Moore; Kolynda Parker, MHS, MLS(ASCP)CM, CPHQ, CLSSBB; Sara Rogers; Melanie Schoenberg; Leslie Short; Angela Smith, PharmD, DHA, MHA, BCPS, FACHE; Lisa Price Stevens MD,MPH, MBA; Priscilla Thode; Vic Tolentino; Gregory Trollan Mark Larson; Lauren Moran, Abena Ohene-Ntow, Disha Uppal

Celebrating a historic milestone! CMS’ approval of waivers in AZ, CA, NM, and OR to cover traditional health care practices for American Indian & Alaska Native communities recognizes the importance of cultural healing and paves the way for other states to take the same action.🌟🌟🌟

Last week, the Centers for Medicare & Medicaid Services (CMS) approved waivers in four states — Arizona, California, New Mexico, and Oregon — that allow Medicaid agencies to cover American Indian and Alaska Native traditional health care practices for the first time. These waivers aim to support sovereign Tribal governments in providing health care services that reflect individual Tribes’ cultures and healing knowledge. This Center for Health Care Strategies Policy Cheat Sheet provides a high-level summary of these groundbreaking waivers, including who is eligible to provide and receive services, how and where services may be delivered, implementation support, and the waivers’ implications for increased Medicaid-Tribal cooperation across states and Tribal communities. These approvals offer a blueprint for other states to work in partnership with Tribal leaders to develop their own waivers. https://bit.ly/4fidXTR Anne Smithey

The United States has one of the highest maternal mortality rates among high-income countries, significantly driven by mental health and substance use disorders (SUD). These behavioral health conditions contribute to over 20 percent of postpartum deaths, primarily through suicide and SUD overdoses. However, promising new evidence-based models focusing on integrated, team-based care, community supports, and medication for addiction treatment, are emerging nationwide, offering hope for improved outcomes and greater birth equity. A new report from the Center for Health Care Strategies examines access to care challenges and outlines key recommendations to support evidence-based, person-centered perinatal services for individuals with mental health disorders and/or SUD. Examples and recommendations can guide states, health plans, health systems, providers, and community-based organizations in improving maternal health and building healthier futures for all. https://bit.ly/3YgmVKz Karla Silverman, Anna Benyo

Social needs screening and follow-up are crucial for identifying and responding to unmet health-related social needs. Screening within Medicaid can promote individual- and population-level health by connecting members to resources, enhancing care quality, integrating social services with health care, and providing insights into community needs. This tool, developed by the Center for Health Care Strategies in partnership with HealthBegins and the Social Interventions Research and Evaluation Network (SIREN) Network, outlines decision points for developing or improving screening policies. It can help state Medicaid agencies advance social needs screening policies and programs based on insights from states participating in the Medicaid Health-Related Social Needs Implementation Learning Series. The tool and learning series are made possible by Kaiser Permanente through its National Community Benefit Fund at the East Bay Community Foundation. https://bit.ly/4eKddHB Kathryn Jantz, Tuyen Tran, Amanda Bank, Caroline Fichtenberg

Trauma-informed, culturally congruent, and team-based care are essential for addressing the complex health and social needs of historically underserved and marginalized communities. On this final day of the Camden Coalition' Putting Care at the Center conference, Armelle Casau, CHCS Associate Director of Child and Family Health, joined Neeti Doshi (Children's Health Center) and Randi Tanksley (Solid Start Initiative) from Zuckerberg San Francisco General Hospital and Trauma Center. Together, they spotlighted innovative approaches that amplify patient voice through human-centered design. Their discussion also underscored how centering storytelling for health care staff can challenge structural racism and drive progress toward more equitable, inclusive care.