Abstract
Patients with psychotic disorders or severe substance use disorders historically have not been well served by traditional fee-for-service care systems, leading to disproportionately high rates of treatment failure, ED visits, inpatient hospitalizations, and a high total cost of care. This case study presents the implementation of Cityblock’s Advanced Behavioral Health program, a model of care led by specialized community health workers, designed to boost access to interventions such as second-generation long-acting injectable antipsychotics, medications for opioid use disorder, medications for alcohol use disorder, contingency management, care coordination, and social care navigation. Members enrolled in the program for a period of 10 months had a statistically significant 19.7% decrease in inpatient utilization and an 11.5% decrease in total per-member, per-month cost of care compared with a quasi-control group. Further research is needed to determine the contribution of each program element to those effects. Since its original implementation, Cityblock has expanded the program to five additional markets and is conducting ongoing research.
Published Version
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