Medicaid Beneficiaries Using Mental Health or Substance Abuse Services in Fee-for-Service Plans in 13 States, 2003

• Published in: Psychiatric services (Washington, D.C.) Vol. 61; no. 9; pp. 871 - 877
• Main Authors: Ireys, Henry T, Barrett, Allison L, Buck, Jeffrey A, Croghan, Thomas W, Au, Melanie, Teich, Judith L
• Format: Journal Article
• Language: English
• Published: Arlington, VA American Psychiatric Association 01.09.2010; American Psychiatric Publishing, Inc
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Child; Child, Preschool; Databases, Factual; Emergency medical care; Fee-for-Service Plans; Female; Humans; Infant; Infant, Newborn; Male; Managed care; Medicaid; Medicaid - statistics & numerical data; Medical sciences; Medicare; Mental disorders; Mental Disorders - drug therapy; Mental Health Services - utilization; Middle Aged; Miscellaneous; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Psychotropic Drugs - therapeutic use; Social psychiatry. Ethnopsychiatry; Substance abuse treatment; Substance Abuse Treatment Centers - utilization; United States; Young Adult; United States; North America; America; Social environment; Human; Health insurance; Psychotropic; Use; Mental health; Hospital environment; Substance abuse; Health service; Emergency department; Treatment; Health economy; Mental disorder; Fee for service; Public health; Age
• ISSN: 1075-2730; 1557-9700
• DOI: 10.1176/ps.2010.61.9.871

This study identified Medicaid beneficiaries using mental health or substance abuse services in fee-for-service plans in 13 states in 2003 (N=1,380,190) and examined their use of medical services. Administrative and fee-for-service claims data from Medicaid Analytic eXtract files were analyzed to identify mutually exclusive groups of beneficiaries who used either mental health or substance abuse services and to describe patterns of medical service use. Overall, 11.7% of Medicaid beneficiaries were identified as using mental health or substance abuse services (10.9% and .7% used each of these services, respectively), with substantial variation across age and eligibility groups. Among beneficiaries using mental health services, 47.4% had visited an emergency room for any reason, 7.8% were treated for their disorder in inpatient settings, 13.8% received inpatient treatment for problems other than their mental or substance use disorders, and 70.4% received prescriptions for psychotropic medications. Among beneficiaries using substance abuse services, 60.7% had visited an emergency room, 12.6% were treated for their disorder in inpatient settings, 24.7% received other inpatient treatment, and 46.1% received prescriptions for psychotropic medications. Among beneficiaries not using either mental health or substance use services, 29.0% had visited an emergency room, 12.7% received inpatient treatment, and 10.1% received prescriptions for psychotropic medications. Beneficiaries who used mental health or substance abuse services entered general inpatient settings and visited emergency rooms more frequently than other beneficiaries.