State Strategies for Integrating Physical and Behavioral Health Services in a Changing Medicaid Environment

States across the country are embracing integrated care delivery models as part of their efforts to deliver high-quality, cost-effective care to Medicaid beneficiaries with both physical and behavioral health needs. The Medicaid expansion authorized by the ACA brings greater import to these efforts, as millions of previously uninsured low-income adults—many at increased risk of having behavioral health conditions—gain coverage. Drawing on a review of the literature and interviews with consumers, providers, payers, and policymakers, this report explores strategies states are deploying to promote integrated care for this medically complex and high-cost Medicaid population.