A Promising Approach to Integrating Physical Health, Behavioral Health, and Social Services
<p><em>Joe, 32, suffered a spinal injury three years ago. Living in a cramped apartment, he is underweight and weak, suffers from pressure sores, and has a thyroid condition. A family member cares for him. Joe feels isolated and depressed. </em></p><p>Joe and others like him are among the most vulnerable members of our society. These are adults living with multiple chronic health conditions, behavioral health problems, or functional limitations resulting from physical and developmental disabilities. Some are homebound, some are homeless. Others cycle in and out of prison as they struggle with severe mental illness or substance abuse. </p>
<p>For the latest profile in our <em>Models for High-Need, High-Cost Patients</em> series, Commonwealth Fund researchers take a close look at the Commonwealth Care Alliance (CCA), a Boston-based Medicare Advantage plan and care delivery network participating in a demonstration designed for complex patients eligible for both Medicare and Medicaid. Integral to CCA’s promising model are flexible benefits that cover services not traditionally reimbursable by the two programs. These allow CCA’s multidisciplinary care teams to work with patients like Joe to identify their unmet physical health, behavioral health, and social service needs and deploy resources as needed.</p>