Chronic Pain & Opioid Addiction: The Role of Integrated Care

The opioid addiction crisis has thrown a spotlight on the physical and behavioral health issues surrounding chronic pain. This briefing examined innovative non-pharmacologic models to address chronic pain, including among the military and veteran population and through state Medicaid and safety net programs.






Assessing Innovations in Medicaid

Medicaid is testing numerous new alternative payment and delivery system models to enhance the coordination of the health care services provided to millions of low-income Americans. This briefing examined the range of Medicaid’s efforts to improve care and promote value, including integrating health with non-clinical and behavioral services, creating managed care organizations, and instituting regional care collaborative organizations. Our panel also addressed Medicaid’s role in managing emerging issues such as the opioid epidemic and the spread of the Zika virus.






Briefing for Reporters on State Health Initiatives

A governor met with reporters Friday, February 19 to discuss the latest health care innovations and changes they are pursuing or implementing. Gov. Asa Hutchinson, R-Ark., discussed his experience with the state’s program to move newly eligible Medicaid beneficiaries to qualified health plans, and his intentions for changes moving forward.






Health Care Out from Behind Bars: Meeting Reentering Prisoners’ Needs Efficiently

Research shows that approximately 40 percent of former federal prisoners and over 60 percent of former state prisoners are rearrested within three years of release and many are re-incarcerated. Individuals transitioning into and out of the criminal justice system include many low-income adults with significant physical and mental health needs. Through outreach and education, correctional facilities are increasingly playing a key role in connecting eligible individuals to health care coverage and other social supports to facilitate their reintegration into the community. The Medicaid coverage expansion is also providing new opportunities to increase health care access to this particular population and potentially improving health outcomes, while bringing down costs. This briefing, the last in our “Medicaid: Beyond the Silos” series, built on last year’s correctional health briefing, with an added focus on reentry programs, and further explored the intersection of health policy and the criminal justice system.






High-Need, High-Cost Patients: The Role of Behavioral Health

Behavioral health conditions, including mental health issues and substance use disorders, affect nearly one in five Americans and account for $57 billion in health care costs annually. This briefing discussed current initiatives to integrate behavioral and physical health care services in order to improve quality of care and reduce overall health care costs.






Between Two Worlds: Adolescents and Our Health Care System

Adolescence is a time of physical, emotional, and cognitive transition between the worlds of childhood and adulthood. This time can include the onset of chronic conditions such as obesity, hypertension, and schizophrenia, yet teens may have difficulty accessing appropriate care for their physical and mental health needs. Emerging models around the country may be improving adolescents’ access to appropriate care, but the evidence suggests many needs are not being met.






Prescription Opioid Abuse: Fighting Back on Many Fronts

According to the Centers for Disease Control and Prevention (CDC), drug overdose is the leading cause of injury death in the United States. In 2010, opioid pain relievers accounted for approximately 17,000 of overdose deaths— more than twice the number of deaths from cocaine and heroin combined. Despite the tremendous importance of prescription drugs in treating pain, some medications have a high risk of being misused or abused. Some researchers have voiced concerns that prescription painkillers could even be a gateway drug for heroin users. With the steady rise in prescription rates and drug overdose deaths, policymakers are coming to a consensus that this national problem must be addressed.






Is the Mind Part of the Body? The Challenge of Integrating Behavioral Health and Primary Care in a Reform Era

As more people gain coverage that includes behavioral health benefits, and given a limited supply of mental health professionals, analysts and advocates are raising concerns over how and whether new laws and regulations will be able to change that situation. One option being explored in many settings is the integration of behavioral health services with primary care. There is early evidence that coordinating care in this manner may deliver high-quality care more efficiently.






Intellectual and Developmental Disabilities in the ACA Era

The Patient Protection and Affordable Care Act (ACA) contains several provisions that address access to community based services for the 4.5 million people in the U.S. with intellectual and developmental disabilities (I/DD). Many of these provisions are aimed at balancing the array of services between those offered in institutions and those in the community.






Shifting Challenges: Mental Health in the ACA Era

Provisions of the 2010 health reform law, combined with mental health parity legislation, promise to make mental health care available to millions more Americans in 2014 through both private insurance and Medicaid. But, the sweeping changes that these laws make to financing for mental health care will require states, mental health providers, private insurers and patients to make major adjustments. As more people gain coverage, mental health experts fear that access to care could become an issue, and members of Congress already are introducing legislation to address this concern.






Mental Health Policy

Mental health problems have been rising in the public consciousness -- with recent mass shootings, with the recession and with the passage of the health reform law. This toolkit offers links to many resources on the scope of the nation's mental health problems and promising ways of addressing them. Includes a list of experts and websites. Supported by the Robert Wood Johnson Foundation.

Healing Mind and Body: Behavioral Health and Reform

The health reform debate has heated up, featuring proposals from both the House and Senate. However, little of the discussion has focused on the area of mental health and substance use disorders. More than 33 million Americans are treated annually for mental health and substance use disorders. Mental illness and substance use disorders can have a profound impact on a person’s overall health and well-being. The passage of the Wellstone-Domenici Mental Health Parity and Addiction Equity Act in 2008 indicated that access to mental health and substance use disorder services is a priority. Yet there are concerns that the cost of accessing this care could rise as mental health parity regulations are implemented concurrent with the possibility that health reform legislation might include expansion of access to mental health services.






The Olmstead Decision Five Years Later: How Has It Affected Health Services and the Civil Rights of Individuals with Disabilities?

For decades, it was routine in the U.S. to house individuals with disabilities in institutions. Those with mental illnesses, for instance, were placed in “insane asylums,” as they were once called. The U.S. Supreme Court took a firm step toward ending this practice five years ago. In the Olmstead v. L.C. decision, the court found that institutional isolation of individuals with disabilities was, under certain circumstances, a violation of the Americans with Disabilities Act.