Access and use of health services by chronically mentally ill Medicaid beneficiaries.
Moscovice, Ira S
Date of Pub
Akhtar, Muhammad R; Christianson, Jon B; Finch, Michael; Lurie, Nicole; Popkin, Michael
This article has two objectives: to quantify the access and utilization of services received by chronically mentally ill Medicaid
recipients, and to compare service utilization and access under prepayment and fee-for-service (FFS) payment. The study setting
is Hennepin County (Minneapolis), Minnesota, where 35 percent of Medicaid recipients were randomly assigned to receive services
from prepaid plans. An algorithm was developed to identify recipients with chronic mental illness, resulting in 739 study
participants, split approximately evenly between prepayment and FFS Medicaid. Data were collected through in-person surveys
at baseline, and after 1 year. We found slight improvements in the majority of access measures studied and no significant
decreases in the use of inpatient or outpatient services for enrollees in prepaid health plans. The results support efforts
to expand the use of prepaid health plans to meet the needs of non-institutionalized chronically mentally ill Medicaid beneficiaries.
Adult : Algorithms : Ambulatory Care/utilization : Chronic Disease/economics/therapy : Community Mental Health Services/utilization
: Comparative Study : Data Collection : Fees, Medical : Health Services Accessibility/statistics & numerical data : Human
: Institutionalization : Male : Medicaid/utilization : Mental Disorders/economics/therapy : Middle Age : Minnesota : Multivariate
Analysis : Prepaid Health Plans/utilization : Regression Analysis : Support, Non-U.S. Gov't : Support, U.S. Gov't, P.H.S.
: United States : Utilization Review/statistics & numerical data