Trauma-Informed Care: Opportunities for High-Need, High-Cost Medicaid Populations

Rachel Davis
Alexandra Maul
March 2015

This resource provides an introduction to trauma‐informed care, describing how it can serve high‐need, high‐cost Medicaid populations. It includes three case studies of innovative programs and a chart describing different approaches.

  • Trauma‐informed care recognizes that much of the behavior demonstrated by patients labeled as “non-compliant” is the result of coping mechanisms to deal with trauma. This approach posits that appropriate treatment can retrain the brain to respond to situations in a healthier way.
  • Key principles of trauma‐informed care include promoting safety, empowerment, peer support, cultural competency, trustworthiness, and collaboration.
  • Southcentral Foundation (SCF) in Alaska, a nonprofit health care organization that serves Native Alaskans, places physical, mental, emotional, and spiritual wellness at the center of its work. SCF’s model is informed by Native Alaskans’ cultural values and beliefs.
  • CareOregon in Oregon embeds workers called Health Resilience Specialists within clinic‐based teams. They receive in‐depth training in active listening, role‐model advocacy, and relational skills.
  • Camden Coalition of Healthcare Providers (CCHP) has begun engaging the broader Camden, New Jersey, community in a dialogue on trauma. Camden joined a cross-sector effort called The Healing 10, in which organizations obtain “Sanctuary Certification,” which entails a three-year certification process in a trauma-informed care approach called the Sanctuary Model.
  • Opportunities for further exploration in this field include assessing the efficacy of different models, measuring the impact of trauma‐informed care on cost and outcomes, and exploring ways to prevent trauma.
Posted to The Playbook on
Population Addressed
People with Multiple Chronic Conditions
People with Behavioral Health and Social Needs
Key Questions Answered
  • What is trauma-informed care, and why is it necessary?
  • What are some examples of organizations that have successfully tried trauma-informed care?
  • What are the characteristics of various approaches?
Level of Evidence
Expert Opinion
What does this mean?