building medicaid/research partnerships: some observations from the ivory tower benjamin druss md,...
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Building Medicaid/Research Partnerships:Some Observations from the Ivory Tower
Benjamin Druss MD, MPHJune 27, 2005
The Mental Health/Primary Care Interface in the Public Sector
•Even wider gap between mental health and primary carein the public sector than in the private sector
The Mental Health/Primary Care Interface in the Public Sector
•Even wider gap between mental health and primary carein the public sector than in the private sector
•Growing evidence that it is possible to improve qualityon the primary care/mental health interface in these settings
The Critical Role of Medicaid
• In the public sector, razor-thin margins mean that reimbursability is critical to sustainability
The Critical Role of Medicaid
• In the public sector, razor-thin margins mean that reimbursability is critical to sustainability
•Medicaid is the dominant funder in these settings
The Critical Role of Medicaid
• In the public sector, razor-thin margins mean that reimbursability is critical to sustainability
•Medicaid is the dominant funder in these settings
• But there are a often a obstacles to funding evidence-based services under Medicaid
Developing Reimbursable Services for Depression in Community Health Centers
• RWJ grant to work with leadership of four Georgia Community Health Centers to improve depression care
Developing Reimbursable Services for Depression in Community Health Centers
• RWJ grant to work with leadership of four Georgia Community Health Centers to improve depression care
•Working with Medicaid to develop strategies for targeting reimbursement for key evidence-based depression services (e.g. case management)
The Fluid Nature of Management/PolicyResearch
• Georgia’s shift to Managed Medicaid
The Fluid Nature of Management/PolicyResearch
• Georgia’s shift to Managed Medicaid
• Now, the intervention has at once become morecomplicated and more simple
The Fluid Nature of Management/PolicyResearch
• Georgia’s shift to Managed Medicaid
• Now, the intervention has at once become morecomplicated and more simple
•New role for the Medicaid office
Lessons Learned
• Policy moves much faster than research
Lessons Learned
• Policy moves much faster than research
• Policy decisions typically rely on a broad range of evidence
Lessons Learned
• Policy moves much faster than research
•Policy decisions typically rely on a broad range of evidence
•Partnerships between researchers and purchasers must be built on a foundation of trust and personal relationships