Medicaid accountable care organizations (ACOs) offer the potential to improve health care quality and control rising costs, particularly for complex, high-need beneficiaries. Given the prevalence of behavioral health conditions among this population and the related cost implications, coordinating behavioral health services within Medicaid ACOs may help states to dramatically improve quality of care and reap significant savings from avoidable emergency room and inpatient utilization.

This brief, made possible by The Commonwealth Fund, outlines considerations to guide state Medicaid agencies in successfully integrating behavioral health services within ACOs. It addresses decisions around financial strategies, data sharing, and quality measurement and identifies policy levers for promoting alignment with existing behavioral health initiatives. As Medicaid ACOs expand their scope of accountability for behavioral health and broader social services (such as housing),  it will be important to identify approaches that support the participation — and accountability — of behavioral health providers.