Strategies for Integrating and Coordinating Care for Behavioral Health Populations: Case Studies of Four States. D. Program Financing and Contracting


The state operates the managed care arrangement with Magellan under the authority of: (1) a 1915(b) waiver for a prepaid inpatient health plan with mandatory enrollment and selective services contracting; (2) a 1915(c) home and community-based waiver; and (3) a 1915(i) state plan option for adult mental health rehabilitation services for adults with SMI. As mentioned above, funding for this program comes from Medicaid and from the pooled funding of several state agencies. The latter source includes SGFs and funding from the Substance Abuse Prevention and Treatment Block Grant. While these funds are pooled into the contract with Magellan, the grant funding is used for its intended population(s).

Although actual cost data were not publically available at the time this report was written, OBH projected per member per month (PMPM) costs for 1915(b) beneficiaries of $56.39 in the first year of the program and $60.90 in the second year of the program (DHH 2011).

View full report


"4CaseStud.pdf" (pdf, 734.19Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®