2026 State of Reform: Advancing whole-person Medicaid in Washington

At the 2026 Washington State of Reform Conference, UnitedHealthcare Community Plan of Washington joined state leaders, providers, and community partners to discuss solutions to strengthen whole-person care for Medicaid populations. The conference highlighted opportunities to advance equity and access to care, including for tribal populations and communities covered by Apple Health Expansion. Key clinical topics included behavioral health, care integration, innovation, and supporting the continuum of care.

Our team participated in discussions centered on two areas where Washington is making progress: integrating behavioral health into primary care and removing barriers impacting transitions of care from acute settings for patients who have complex health needs.

Integrating behavioral health care into primary care settings

About half of people who have a mental illness don’t receive behavioral health treatment.¹ Many people seeking behavioral health care turn first to their primary care provider (PCP), an indicator of patients’ trust in their PCPs and the need to bring evidence-based behavioral health into that setting.

The Collaborative Care Model (CoCM) brings evidence-based behavioral health care to the primary care setting with a team-based approach, psychiatric consultation, and measurement-based care. CoCM creates a patient-centered approach and encourages early, proactive support by enabling patients to access behavioral health as a routine part of primary care.

A case study presented during the panel showed the financial impacts of the model. A provider with 2,500 patients implemented CoCM and found that it improved both physical and behavioral health, decreased inpatient psychiatric and emergency department utilization, and generated cost savings.

Integrating behavioral health care into primary care is an important lever for increasing behavioral health capacity in Washington. Patients can be seen more quickly in the setting they prefer, reducing demand for specialty behavioral health services and making those services accessible for patients with more acute needs.²

Strengthening systems to improve complex discharge

Washington’s Complex Discharge Pilot addresses a persistent challenge: patients who are medically ready to leave the hospital but remain for weeks or months because the system cannot connect them to appropriate next steps. On a typical day, approximately 850 people across Washington face barriers to acute care discharge, including medical, behavioral, and social needs.³

The Washington State Legislature established a pilot program and task force in 2023 test a model to improve transitions for complex patients and to develop recommendations to address underlying systemic barriers. The pilot tested a patient-centered model, focused on Medicaid enrollees with complex needs. The model includes:

• Enhanced care management teams to follow patients through the continuum of care
• Partnerships with post-discharged providers
• Supportive services to address patient-level barriers
• Dedicated long-term care eligibility staff
• Multidisciplinary care teams that convene weekly to coordinate care

Early outcomes from the pilot showed improvements in reducing hospital and skilled nursing length of stay, lowering costs, and high patient satisfaction. Following the pilot, the task force developed eight recommendations for practical investments and strategies to make existing programs work better for patients. UnitedHealthcare Community Plan of Washington participated in the task force and provided perspective on the role of managed care organizations in supporting timely discharges and building transparent processes.

Moving care forward for Washingtonians

For UnitedHealthcare Community Plan of Washington, participating in these discussions affirm our commitment to removing barriers to care and advancing models that can create a more equitable and responsive health system serving Washington.