Building Medicaid/Research Partnerships: Some Observations from the Ivory Tower

1. Building Medicaid/Research Partnerships: Some Observations from the Ivory Tower Benjamin Druss MD, MPH June 27, 2005

2. The Mental Health/Primary Care Interface in the Public Sector • Even wider gap between mental health and primary care • in the public sector than in the private sector

3. The Mental Health/Primary Care Interface in the Public Sector • Even wider gap between mental health and primary care • in the public sector than in the private sector • Growing evidence that it is possible to improve quality • on the primary care/mental health interface in these settings

4. The Critical Role of Medicaid • In the public sector, razor-thin margins mean that • reimbursability is critical to sustainability

5. 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

6. 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

7. 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

8. 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)

9. The Fluid Nature of Management/PolicyResearch • Georgia’s shift to Managed Medicaid

10. The Fluid Nature of Management/PolicyResearch • Georgia’s shift to Managed Medicaid • Now, the intervention has at once become more • complicated and more simple

11. The Fluid Nature of Management/PolicyResearch • Georgia’s shift to Managed Medicaid • Now, the intervention has at once become more • complicated and more simple • New role for the Medicaid office

12. Lessons Learned • Policy moves much faster than research

13. Lessons Learned • Policy moves much faster than research • Policy decisions typically rely on a broad range of evidence

14. 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