Headline

Detailed examples of state language to advance greater integration of behavioral health by plans serving dually eligible individuals.

Background

Dually eligible individuals have high rates of behavioral health conditions, and must navigate behavioral health service coverage within Medicare and Medicaid, in addition to navigating coverage for physical health care and long-term services and supports. This technical assistance tool describes how states can design their State Medicaid Agency Contracts (SMACs) with dual eligible special needs plans (D-SNPs) to support greater integration of physical and behavioral health care.

Findings

States can include contract requirements in their SMACs related to behavioral health training, interdisciplinary care teams, health risk assessments, crisis response and care transitions, provider networks, and data-sharing. The tool includes examples of state language related to each approach. It also includes brief case studies of D-SNPs that advanced greater integration beyond these requirements.

Policy/Program Takeaways

These strategies can inform state approaches to designing their contracts with D-SNPs to improve integration of physical and behavioral health care.