2015 APHA Annual Meeting & Expo

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Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

335261
Utilization and associated outcomes of behavioral healthcare services in HMOs vs. specialty behavioral healthcare managed care plans


Wednesday, November 4, 2015 : 10:50 a.m. - 11:10 a.m.

Gregory Teague, Ph.D., Dept. of Mental Health Law and Policy / FMHI /College of Behavioral & Community Sciences, University of South Florida, Tampa, FL
Mary Rose Murrin, M.A., Department of Mental Health Law and Policy / Louis de la Parte Florida Mental Health Institute, University of South Florida, Tampa, FL
Audio (mp3) recording Recorded Presentation (mp4)
Background/purpose. During 2008-2012, behavioral healthcare services were provided to Medicaid beneficiaries in a large State through multiple health plans under a 1915(b) waiver authority. Utilization and selected outcomes were examined for selected populations of plan enrollees in 26 plans, most either general health maintenance organizations (HMOs) or prepaid mental health plans (PMHPs). This presentation offers findings from an evaluation of the utilization of behavioral healthcare service types and two outcomes, involuntary psychiatric evaluation (IPEs) and arrests.

Methods. Enrollee population groups included persons discharged from a psychiatric inpatient stay, adults beginning a new episode of anti-depressant medication treatment, adults diagnosed with Schizophrenia, adults diagnosed with Bipolar Disorder, and other groups. Utilization was operationalized as penetration rates of categories of behavioral health services for each group by plan. Analyses included comparisons of utilization of service categories and outcomes by plan type, and correlation of utilization and outcomes using plan as unit of analysis, weighted by enrollment.

Findings. Overall penetration rates for behavioral healthcare service types were significantly higher for PMHPs than HMOs.  Adult diagnostic and inpatient discharge groups receiving services through PMHPs showed significantly lower rates of IPEs and arrests than persons served through HMOs. Arrest rates across plans were significantly inversely related to service penetration rates for these groups, particularly for the Schizophrenia group, for which IPE rates were similarly related.

Implications. For persons with more severe mental health symptoms, enrollment in health plans giving specific attention to behavioral health is associated with greater use of behavioral health services, and such use is associated with better outcomes.

Learning Areas:

Conduct evaluation related to programs, research, and other areas of practice
Other professions or practice related to public health
Provision of health care to the public
Public health administration or related administration

Learning Objectives:
Describe associations among type of healthcare plan, utilization of behavioral healthcare services, and legal and acute psychiatric outcomes

Keyword(s): Managed Care, Mental Health Treatment &Care

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been the principal or co-investigator of funded research in the area of mental health services and was the principal investigator of the study from which the presented content was drawn.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5120.0: Research Perspectives on Behavioral Health Policy: Mental Health Courts, Olmstead Settlement, Medicaid Managed Care, Medical Legal Partnerships