Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109274

Wenhui Wei, MA, MS¹, Yujing Shen, PhD², Patricia A. Findley, DrPH, MSW³, James T. Walkup, PhD⁴, and Stephen Crystal, PhD¹. (1) Institute for Health, Health Care Policy, and Aging Research, Rutgers University, 30 College Ave, New Brunswick, NJ 08901, (2) Institute for Health, Health Care Policy and Aging Research, Rutgers, the State University of New Jersey, 30 College Ave., New Brunswick, NJ 08901, 732-9327190, yshen@ihhcpar.rutgers.edu, (3) Program for Disability Research, Rutgers University, 303 George Street, Suite 405, New Brunswick, NJ 08901, (4) Rutgers University, Institute for Health, Health Care Policy, and Aging Research, 30 College Avenue, New Brunswick, NJ 08901

RESEARCH OBJECTIVE: Evaluates the impact of dual eligibility on Medicaid prescription drug expenditures among non-elderly Medicaid beneficiaries diagnosed with severe mental illness (SMI). STUDY DESIGN: We used personal summary information and medical claims data from 2000 New Jersey Medicaid Extract Files. Unadjusted subgroup differences in the average amount of Medicaid prescription drug expenditure between Medicaid-only and dual-eligible was tested with T-statistics. Ordinary least square regressions were used to estimate Medicaid prescription drug expenditure. POPULATION STUDIES: NJ full-year fee-for-service Medicaid enrollees aged 18-64 and diagnosed with SMI.PRINCIPLE FINDINGS: Overall, 41% (n=7,087) of Medicaid beneficiaries diagnosed with SMI were eligible for Medicare. Being male, White American, middle-aged, presence of substance abuse and less severity of mental illness were less likely to be dual-eligible. Among the dual-eligible, disability was the predominant reason for both their Medicaid and Medicare eligibilities, and 96% were enrolled full-year in Medicare. On average, dual-eligible beneficiaries filled 63 prescriptions in 2000, and Medicaid paid $4980, significantly higher than those of Medicaid-only. Among those dual-eligible, racial minorities were more associated with lower number of prescriptions and had lower prescription drug expenditures. CONCLUSION: Among non-elderly Medicaid beneficiaries with SMI, there was significant difference in prescription drug expenditures between Medicaid-only and dual-eligible. Significant racial disparity in getting prescription drug existed among those with dual eligibility. IMPLICATION OF POLICY: State policy should be designed to help dual-eligible with SMI to migrate to the Medicare Part-D plan that may offer less comprehensive and secure benefits.

Learning Objectives:

• The learner will
• a) Analyze the correlates of dual eligibility among Medicaid beneficiaries diagnosed with severe mental illness and their prescription drug expenditures.
• b) Evaluate the needs for appropriate design and implementation of State policy on prescription drugs to complement Medicare Part-D program for the current dual-eligible Medicaid beneficiaries with severe mental illness.

Keywords: Sever Mental Illness, Cost Issues

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation