Market Intelligence Reports


Overview Of State DSRIP Programs: The 2017 OPEN MINDS Market Intelligence Update

Market Intelligence Report | August 24, 2017
As of July 2017, eight states—California, Kansas, Massachusetts, New Hampshire, New Jersey, New York, Texas, and Washington—have Delivery System Reform Incentive Payment (DSRIP) programs. DSRIP programs were initially designed to replace lost funding due to the onset of managed...

Access To Medication Assisted Treatment For Opioid Addiction

Market Intelligence Report | April 6, 2017
Medication-assisted treatment (MAT) uses a combination of prescription drugs and behavioral treatment to address addiction, and is an important tool in combating the overuse of both legal and illegal opioids. To assess the market opportunity of MAT services, OPEN...

An Update On States With Medicaid 1115 Waivers For Addiction Treatment

Market Intelligence Report | February 10, 2017
In July 2015, the Centers for Medicare & Medicaid Services (CMS) released a new 1115 demonstration waiver opportunity for states, generally known as substance use disorder (SUD) delivery system transformation. Under the delivery system, transformation states are encouraged to...

2016 Medicaid Enrollment In Care Coordination Initiatives

Market Intelligence Report | January 26, 2017
The past seven years have seen an increase in the number of states implementing care coordination initiatives with the goal of improving the quality of patient care while at the same time bending the health care cost curve. State...

State Medicaid Behavioral Health Carve-Outs: The OPEN MINDS 2017 Annual Update

Market Intelligence Report | January 16, 2017
Carve-outs are Medicaid managed care financing models where some portion of Medicaid benefits—dental services, pharmacy services, behavioral health services, etc.—are separately managed and/or financed. In Medicaid behavioral health financing arrangements, there are five main models that states use to...

State Medicaid Programs With MLTSS: The 2016 OPEN MINDS Update

Market Intelligence Report | December 20, 2016
Managed long-term services and supports (MLTSS) refers to state Medicaid programs that choose to finance and manage institutional care and/or HCBS through managed care organizations (MCOs). State Medicaid plan contracting for MLTSS can either be through existing Medicaid MCO...

Spending Trends For The Medicaid-Medicare Dual Eligible Population

Market Intelligence Report | December 16, 2016
Dual eligibles, sometimes referred to as Medicare-Medicaid enrollees, are consumers that due to disability, age, and/or income are eligible to enroll in both Medicare and Medicaid. OPEN MINDS analysis found that total spending for the dual eligible population was...

The 2016 OPEN MINDS Medicaid ACO Trend Update

Market Intelligence Report | December 1, 2016
Accountable care organizations were originally developed as a Medicare construct as part of the Patient Protection and Affordable Care Act (PPACA) to improve care coordination and lower the cost of care. State Medicaid programs have taken the Medicare ACO...

Key Features Of Medicaid Behavioral Health Episodes Of Care

Market Intelligence Report | October 27, 2016
Generically, the term episode of care (EOC) means a bundled reimbursement for all health care services delivered in response to a particular health issue or for a package of treatment services that can be defined by diagnosis, time, or...

The U.S. Mental Health Market: $195.6 Billion In Spending In 2015

Market Intelligence Report | October 6, 2016
In 2015 mental health spending was $195.6 billion. U.S. per capita spending for mental health services in 2015 was approximately $608.49 per person. When mental health spending is broken down by payer, private insurance was the largest payer of...

The Addiction Treatment Market: $36 Billion In Spending In 2015

Market Intelligence Report | October 6, 2016
In 2015 addiction treatment spending was $36 billion. U.S. per capita spending for addiction treatment services in 2015 was approximately $112.08 per person. The addictions treatment services market includes health services for addiction and substance abuse. Addictions treatment services are...

The 2016 OPEN MINDS Medicare ACO Update: A Three-Year Trends Report

Market Intelligence Report | September 19, 2016
As of 2016, there are a total of 460 accountable care organizations (ACOs) participating in different Medicare ACO models, an increase of 200% from 2012 when there were a total of 150 ACOs. The Medicare Shared Savings Program is...

U.S. Medicaid Health Home Market: The 2016 OPEN MINDS Update

Market Intelligence Report | September 14, 2016
Medicaid health homes are a population-based integrated care service delivery model for individuals with chronic conditions and serious mental illness (SMI). They are not a physical space, which is a common misconception about the term. The model, as outlined...