Market Intelligence Reports


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...

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...

The 2016 OPEN MINDS Medicaid Managed Care Market Share Report

Market Intelligence Report | August 1, 2016
Managed care is the dominant Medicaid contracting model with 68.8% of the 75 million Medicaid enrollees receiving services through an at-risk managed care organization (MCO). In states with managed care, the Medicaid program generally contracts with a mixture of...

The 2016 OPEN MINDS Medicaid Managed Care Update: A State-By-State Analysis

Market Intelligence Report | July 28, 2016
In understanding the impact of Medicaid and Medicaid managed care in any state, there are three key elements: the financing mechanism, the services provided, and the populations that are included. Generally, there are three financing mechanisms for the delivery...