Market Intelligence Reports | June 20, 2014
Which States Carve Behavioral Health Benefits Out Of Medicaid Managed Care Contracts?
A carve-out is a Medicaid financing model where some portion of Medicaid behavioral health benefits— mental health outpatient, psychiatric inpatient, addictions, pharmacy, etc. —is separately managed and/or financed on an at-risk basis by another organization or retained by the state Medicaid agency on a fee-for-service (FFS) basis. The carve-out can take place at one of two levels: At the payer level — referred to as a primary carve-out; and at the health plan level — referred to as a secondary carve-out). This report looks at the distribution by predominant model in states . . .