Behavioral health disorders are among the most prevalent and disabling chronic conditions affecting Medicare-Medicaid beneficiaries. These individuals have complex needs that require closely coordinated services, but misalignments between Medicare and Medicaid often result in fragmented, poor quality care.

This brief, made possible through support from The Commonwealth Fund and The SCAN Foundation, describes early efforts in four states — Arizona, California, Massachusetts, and Washington — to improve integration of behavioral health services for Medicare-Medicaid beneficiaries. It outlines: (1) how states are using Medicaid behavioral health system capacity to advance care coordination and establish better integration with Medicare; and (2) common elements of effective physical/behavioral health integration strategies. While the states profiled are at early stages of implementation, initial lessons can be extracted from their experiences to inform other states.