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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Kristine Jones, PhD1, Huey J. Chen, PhD2, Roger Boothroyd, PhD2, and David L. Shern, PhD2. (1) Statistical Sciences & Epidemiology Department, Nathan S. Kline Institute, 140 Old Orangeburg Road, Bldg 37, Orangeburg, NY 10962, 914-398-6598, Jones@NKI.RFMH.ORG, (2) Louis de la Parte Florida Mental Health Institute, University of South Florida, 13301 North Bruce B. Downs Blvd, Tampa, FL 33612
The existence of three Medicaid health/mental health insurance arrangements (i.e., a mental health carve-out, a carve-in and fee for service) in Florida offer an ideal environment to consider the effect of managed care on cost shifting and substituting between mental health, medical, pharmaceutical and substance abuse services as well as between formal and informal providers. Also of interest is if there is any impact on total social cost. Findings will be summarized from a social cost analysis of 688 adults with severe mental illness enrolled in one of three Medicaid plans in Florida. Self-reported service utilization data were collected on a bi-monthly basis over a 15-month period. Information included the frequency and intensity of use of mental health, general health, pharmacy and other social services, housing, criminal justice contacts and income allowing the construction of a total social cost measure. Details on actual providers and copayments allows for an investigation into financial burden distribution differences among persons enrolled in different plans. Preliminary analyses showed a trend toward higher psychiatric inpatient, outpatient and emergency service costs; and significantly lower cost in formal off-budget mental health services for persons enrolled in a fee for service delivery system as compared to persons enrolled in either managed care plan. For this presentation, the analysis will be extended to plan enrollment effects on formal and informal medical, pharmaceutical and substance abuse services costs. Difference in total cost and differences in the composition of costs between plans will also be discussed.
Learning Objectives:
Keywords: Cost Issues, Mental Health System
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.