Comprehensive Care for People with Serious Mental Illness
Addressing whole health, not just mental health
Our Comprehensive Care for People with Serious Mental Illness (CCPSMI) program is a whole-person, data-driven solution that brings together medical care, behavioral health, pharmacy services, and social support.
With personalized support and dedicated care teams, our program increases member engagement and helps people with serious mental illness (SMI) live healthier and more stable lives.
Lines of business
- Commercial
- Employer
- Medicaid
- Medicare
- Public sector
Why holistic care works for people with SMI
When a person is diagnosed with SMI, it means they have a behavioral or mental health condition that is severe, long-lasting, and significantly impairs their ability to manage daily tasks. SMI often occurs alongside other conditions, like cardiovascular disease, chronic obstructive pulmonary disease, cancer, diabetes, and liver disease.1
People with SMI often have gaps in care. Without early identification and engagement, these gaps may lead to preventable crises and hospitalizations. Social concerns, like housing, food, and transportation, can also hinder stability and recovery.
By looking at a person’s whole health, our team can identify solutions that consider conditions, circumstances, and medications to improve outcomes.
10% reduction
in avoidable BH inpatient utilization2
4% lower
monthly avoidable behavioral health costs2
Our integrated approach:
- Connects people to the right care sooner
- Supports long-term recovery
- Reduces avoidable high-cost care
8% fewer
avoidable ER visits3
16% fewer
avoidable inpatient stays3
140% higher
member engagement3
Clinical excellence and network strength support recovery
Our CCPSMI program is built on two pillars — clinical excellence and network strength — and is supported by pharmacy, quality, and social drivers of health (SDoH).
On the clinical side, members have access to proven care pathways that match their most pressing needs, including support for substance use disorders and suicide prevention.
On the network side, our care provider and value-based partnerships expand access to community services that support recovery and foster independence. These partnerships also help drive savings.
Our pharmacy, quality, and SDoH programs strengthen both pillars and extend the reach of our interventions.
This integrated network supports seamless access and local care delivery at scale.
Data and technology strengthen our outreach
Our population care match engine and predictive models help us identify care needs and cost drivers. That helps us focus on members most likely to engage and benefit from clinical intervention.
Our configurable electronic health record (EHR) pulls real-time data from EHRs, health information exchanges, claims, and social drivers of health. This data helps guide decisions, improve workflow efficiency, and deliver better results for our partners.
What we do differently
Our team works closely with each individual to create a personalized care plan that can improve their quality of life.
Proactive, data-driven outreach identifies potential risks early and helps prevent crises
Whole-person care coordinates behavioral health, medical, pharmacy, and social support
Consistent, community-based engagement provides access to dedicated care teams and peer support
Helping our partners solve complex challenges
For our partners, Carelon’s CCPSMI program supports end-to-end risk management and delivers a unified population health approach that meets state regulatory needs.
CCPSMI is a scalable model that brings together people, data, and technology to improve outcomes, deliver financial value, and help people with serious mental illness live healthier, more stable, and more connected lives.
Learn more about our program
Discover how our CCPSMI services deliver measurable results. Together, we can improve outcomes for your Medicaid population.
1 Launders N, Dotsikas K, Marston L, Price G, Osborn D, Hayes JF: The impact of comorbid severe mental illness and common chronic physical health conditions on hospitalisation: A systematic review and meta-analysis. PLOS One (August 18, 2022): https://doi.org/10.1371/journal.pone.0272498
2 Carelon cost and trend analysis: Behavioral health claims, January 2024–September 2025.
3 Carelon internal data, 2025.