Impact of a mental health based primary care program on emergency department visits and inpatient stays

Abstract

Introducing primary care services into mental health clinics may increase utilization of inpatient services, perhaps due to newly identified unmet medical need in this population.

Impact of the 1115 behavioral health Medicaid waiver on adult Medicaid beneficiaries in New York State

“…Although several studies have examined the impact of integrated MMC "carve-in" for Medicaid beneficiaries with behavioral health conditions, the findings have been mixed with some evidence of effectiveness. 12,26,27 Nevertheless, much of the findings seem to suggest that MMC leads to reductions in medical cost, ER visits, fewer inpatient stays, and increased outpatient use. 12,28,29 While the findings of this study suggest that HARPs were associated with a relative increase in outpatient services, a relative reduction in inpatient stays and length of stays, and a relative decline in ER services, it is of note that service use in both groups generally declined in the pre-to post-HARP period comparisons.…”

“…Although several studies have examined the impact of integrated MMC “carve‐in” for Medicaid beneficiaries with behavioral health conditions, the findings have been mixed with some evidence of effectiveness 12,26,27 . Nevertheless, much of the findings seem to suggest that MMC leads to reductions in medical cost, ER visits, fewer inpatient stays, and increased outpatient use 12,28,29 …”

Systematic Review of the Impact of Behavioral Health Homes on Cardiometabolic Risk Factors for Adults With Serious Mental Illness

“…Studies were categorized as low risk of bias (good quality) (N=11) (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25), moderate risk of bias (medium quality) (N=6) (26)(27)(28)(29)(30)(31), and high risk of bias (poor quality) (N=1) (32) (Table 1). The most common causes for methodological quality concerns among studies were failure to report participants' baseline characteristics, lack of blinding of assessors, unclear description of the intervention or its delivery, no mention of statistical power, and infrequent assessment or a single assessment of outcomes.…”

Integration of Primary Care and Behavioral Health

“…A study of 752 patients with SMI in 2 integrated behavioral health clinics, 1 established and 1 new, evaluated hospital utilization and costs (Breslau et al, 2018). In the established integrated care clinic, patients receiving integrated care services had reduced inpatient hospital admissions after enrollment in the integrated program, as compared to non-enrolled patients in the clinic.…”