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Integrating school-based health centers into managed care in Massachusetts.

Contemporary school-based health centers (SBHCs) face dwindling financial resources and pressures to maximize reimbursement. As managed care becomes the dominant system of health care financing, SBHCs must integrate their service delivery with managed care systems. In Massachusetts, through a combination of advocacy, state, and local collaboration, SBHCs successfully developed partnerships with managed care plans. Strategies include enhancing communication between SBHCs and health maintenance organizations, standardizing school-based care, and mandating integration of services through state contract language. This article delineates the process that occurred and key elements necessary for developing these relationships. This experience is a valuable resource for other states and school-based providers as Medicaid populations are funneled into managed care arrangements.