New Molina Program Brings Care Management To The Criminal Justice System

by Molina Healthcare

October 3, 2017

It is no secret that people who have spent time in jail are more likely to be low-income and to have substance abuse histories. As solutions for these issues go unmet, problems tend to recur or worsen, which can drive up health care costs and increase chances of recidivism, or the tendency of a convicted criminal to re-offend.

Medicaid health plans are in a unique position to help decrease costs and rates of recidivism through active care management of individuals involved in the criminal justice system. Molina Healthcare has already seen exciting progress in programs we’ve been a part of in Ohio and New Mexico.

Taking a closer look at New Mexico, Molina partnered closely with both the New Mexico Human Services Department (HSD) and the Metropolitan Detention Center in Albuquerque to help inmates successfully return to the community. By coordinating behavioral and physical health services while also improving medication adherence, the goal is to reduce inappropriate emergency room utilization and reduce recidivism. The focus on care coordination also allows for Molina to connect people to helpful resources to support social determinants of health, such as housing, employment, and more.

A key to the program’s success has been to make contact with the member prior to his or her release. During this interaction, care coordinators learn how Molina can best support the member once they are released. Uniquely, Molina care coordinators receive special training that enables them to move about safely and freely in the detention center, with access similar to that of the detention center guards.

“We have been very pleased with the preliminary results of the program Molina has piloted in New Mexico to help individuals being released from jail return to the community and manage their health care,” said Nancy Smith Leslie, Medicaid Director for the State of New Mexico. “We are excited to expand upon the program in order to continue decreasing costs to both the health care and the justice systems.”

Although Molina’s pilot with the state of New Mexico is fairly new and more time and participants are required to determine long-term impacts, the initial results are very encouraging. The individuals participating in the program so far have a 16 percent recidivism rate compared to the average rate of 56.7 percent. Additionally, emergency department use by the members participating in the pilot is 64 percent lower than their peers who did not participate. Given the success of the program to date, Molina is in the process of expanding to jails statewide. The state of New Mexico has also recognized the success of the program and is requiring all Medicaid health plans to begin working on similar programs to expand the success of Molina’s model.

To understand the significant impact this program can have on the individuals going through this difficult transition, please watch the video below highlighting one member’s experience.