Best Practices: MEDNET: A Multistate Policy Maker–Researcher Collaboration to Improve Prescribing Practices

Abstract

States face new federal requirements to monitor psychotropic prescribing practices for children and adults in Medicaid. Effective use of quality measurement and quality improvement strategies hold the promise of improved outcomes for public mental health systems. The Medicaid/Mental Health Network for Evidence Based Treatment (MEDNET) is an AHRQ funded multi-state Medicaid quality collaborative with the Rutgers University Center for Health Services Research on Pharmacotherapy, Chronic Disease Management, and Outcomes. We review the development, infrastructure, challenges, and early evidence of success of this public-academic partnership, the first multi-state Medicaid quality improvement collaborative to focus on psychotropic medications.

Use of Pooled State Administrative Data for Mental Health Services Research

“…Accessing state data and linking Medicaid data with other state administrative data, or across state Medicaid programs, requires a significant investment of time for both the academic and state partners. Consistent with other reports (Finnerty et al 2014), in some states, it took university-based investigators half of the 3-year study timetable to develop acceptable data use agreements with state agencies and their contracted data vendors (sometimes separately) to link files with Medicaid claims. In one state, researchers found that key variables, such as eligibility, were not available at the individual level, and that race/ethnicity or cross-system involvement were typically not reported, with the net result that the interagency data was of limited use.…”

“…Researchers interested in establishing new public-academic partnerships should plan for dedicated time to establish these data sharing agreements and protocols. One benefit of grant-funded public academic partnerships is that once established, data access protocols are easier to expand and sustain, building a foundation for future work (Finnerty et al 2014). …”

“…These findings, along with similar results for adults, supported the continuation and expansion of the HIT CQI program in NY to other quality measures and settings. Further, this approach has been expanded to other states through an Agency for Healthcare Research and Quality funded multi-state quality collaborative (Finnerty et al 2014). The prior authorization study highlighted that this commonly-used pharmacy benefit management strategy may not work for all populations and medications.…”

A best‐worst scaling experiment to identify patient‐centered claims‐based outcomes for evaluation of pediatric antipsychotic monitoring programs

“…43,44 MEDNET was a multi-state Medicaid quality collaborative with a public-academic partnership housed at the Rutgers University Center for Health Services Research. 45 Prior to pilot testing and fielding the quantitative preference survey, cognitive interviews of the drafted instruments were conducted with individuals from each of the relevant groups to increase construct validity of measures and identify strategies to reduce cognitive burden. 46 With foundations in cognitive psychology and information processing theory, cognitive interview techniques were used to increase readability, comprehension, and relevance of information, improving the construct validity and reducing cognitive burden.…”

Optimizing the Impact of Public-Academic Partnerships in Fostering Policymakers’ Use of Research Evidence: Proposal to Test a Conceptual Framework

“…About 20% of US youths aged 13-16 years will experience a psychiatric disorder during their lifetime [2-4], and the rates are higher among youth served by the public care sector [5-7]. PAPs are vital to improve the health and well-being of vulnerable populations [8-11]. PAPs seek to bridge the historic divide and disconnect that has evolved among researchers and policymakers and improve the degree to which the knowledge generated by researchers is utilized for the benefit of the individuals being served by the public care sector [12,13].…”