Strategies for Integrating and Coordinating Care for Behavioral Health Populations: Case Studies of Four States. B. Creative Financing of Services


The states included in these case studies creatively used a range of funding mechanisms in an attempt to better coordinate and integrate care for individuals with behavioral health conditions. Some states have pooled funding across state agencies or health care payers. Other states have relied exclusively on federal waivers to allow Medicaid to fund services. States have also relied on state, federal, and private grants to get their program off the ground or to fund specific initiatives. Louisiana used several Medicaid managed care waivers, home and community-based services waivers, and a state plan option to finance a CSoC. North Carolina used grant funding from a private health care philanthropy to fund its first program, the Wilson County Health Plan, from which CCNC evolved. The state later used a Section 1915(b) waiver to create CCNC; eventually, the program was written into the Medicaid state plan via an amendment. Vermont and Tennessee both used Section 1115(a) demonstration waivers to fund their programs, while Vermont also used the Medicaid Health Home state plan option to finance Blueprint. In sum, these states have harnessed the available funding streams in an effort to move toward a service delivery system that overcomes historical silos of care.

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