Cambridge Health Alliance | Somerville, MA
Studies have found that Medicaid patients with serious mental illnesses have a significant mortality gap compared with the Medicaid population without serious mental illness. For example, people with schizophrenia die an average of 27.5 years younger—and this disparity is mostly caused by greater incidence and severity of medical conditions, including cardiovascular disease, metabolic disorders, lung disease, various cancers, and other common medical ailments.
To address this discrepancy, Cambridge Health Alliance (CHA), an academic community health system located just outside Boston, decided to launch a “Behavioral Health Home” program in 2015. This service model, piloted in Somerville, Mass., is designed to integrate medical services and care management with mental health care to offer more comprehensive, team-based care in an outpatient mental health clinic. The core idea is that mental health clinics may be a more comfortable and effective medical home for people with serious mental illness (psychotic disorders, bipolar disorder, personality disorders, PTSD, obsessive-compulsive disorder, etc.) than traditional primary care practices. CHA adopted the Behavioral Health Home specifically to improve care for people with schizophrenia-spectrum and bipolar disorders. The program serves CHA patients on a variety of health plans, though more than 90 percent are public payer.