New Opportunities In The Shifting Medicaid Carve-Out Market

The Medicaid carve-out market is shifting. Last month, a Michigan House appropriations panel approved two new financing pilot models to help the state integrate Medicaid physical and behavioral health services by 2020 (see Michigan Legislative Panel Approves Financing Models For Integrated Care Pilot Projects). Currently, Michigan operates a Medicaid carve-out for behavioral health services, which are managed by 10 regional mental health authorities structured as prepaid inpatient health plans (PIHPs). In the new financing models, one would be a statewide prepaid inpatient health plan (PIHP) to manage behavioral health services (replacing the 10 regional mental health authorities); and . . .