Perspective: Public-Sector Mental Health Care: New Challenges

Hogan, Michael

doi:10.1377/hlthaff.18.5.106

Cited by 14 publications

(8 citation statements)

References 10 publications

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“…Like in other states, however, increasing budget pressures have encouraged the greater use of Medicaidreimbursable services over-state funded services. 26,27 Funding for the SMHS comes from Medicaid and non-Medicaid state mental health dollars, which are pooled into a single funding stream. By blending funds together, the state hopes to avoid the problems inherent in categorical funding and Bcreate a one-tiered system of care governed by uniform standards.^2 8…”

Section: Maryland_s Medicaid Managed Care Behavioral Health Care Programmentioning

confidence: 99%

The Effect of a Medicaid Managed Care Program on Patterns of Psychiatric Readmission Among Adolescents: Evidence from Maryland

Fontanella

Zuravin²,

Burry³

2006

J Behav Health Serv Res

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This study evaluates the effect of Maryland's Medicaid managed care program on patterns of psychiatric readmission for adolescents. Rates and frequency of readmissions are compared before (FY 1997) and after (FY 1998) the implementation of Maryland's Medicaid managed care program. Medicaid claims files were reviewed for 881 adolescents consecutively admitted to three major Maryland psychiatric hospitals between July 1, 1996 and June 30, 1998. Adolescents admitted after the managed care reforms were more likely to experience multiple readmissions. The 1-year cumulative rate of readmission pre- and postmanaged care was 33% and 38%, respectively; the highest risk period fell within the first 15-30 days postdischarge. The high rate of early readmissions raises concern about the quality of care and the adequacy of community-based services. Findings also suggest that youths with serious emotional disturbances who are high users of inpatient care may be adversely affected by the managed care reforms.

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Section: Maryland_s Medicaid Managed Care Behavioral Health Care Programmentioning

confidence: 99%

The Effect of a Medicaid Managed Care Program on Patterns of Psychiatric Readmission Among Adolescents: Evidence from Maryland

Fontanella

Zuravin²,

Burry³

2006

J Behav Health Serv Res

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“…Presently, the most effective treatment for schizophrenia involves the use of antipsychotic medications (Rittmannsberger, Pachinger, Keppelmuller, & Wancata, 2004). However, growing concerns over rapidly rising expenditures for these drugs have made benefit versus price a critical issue (Fichtner, Hanrahan, & Luchins, 1998;Gardner et al, 2003;Gibson, Dalmer, Jackson, Wilder, & Ramsey, 2004;Hogan, 1999). Faced with skyrocketing Medicaid expenditures, many states are adopting restrictive prescribing policies (e.g., mandatory generic requirements, prior authorization, medication algorithms, drug formulary restrictions, and preferred drug lists) to contain these costs (Awad & Voruganti, 2004;Becker & Lemrow, 2004;Boyd, 2003;Geddes, Freemantle, Harrison, & Bebbington, 2000).…”

Section: Introductionmentioning

confidence: 99%

The Relationship of Antipsychotic Medication Class and Adherence with Treatment Outcomes and Costs for Florida Medicaid Beneficiaries with Schizophrenia

Becker

Young

Ochshorn

et al. 2007

Adm Policy Ment Health

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While some studies show a significant advantage in adherence rates with use of atypical versus typical antipsychotic medication, others show no advantage or mixed results (Jones et al. (2006). Archives of General Psychiatry, 63, 1079-1087; Rosenheck, (2006). Archives of General Psychiatry, 63, 1074-1076). This study examined treatment outcomes and costs associated with adherence rates by antipsychotic medication class for adult Medicaid beneficiaries in Florida diagnosed with schizophrenia. Outcomes examined include arrests, involuntary commitments, and physical and behavioral healthcare costs. Study findings demonstrate that medication adherence for persons with schizophrenia may be as important to treatment costs and benefits as the class of medication used.

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“…In the center of all this are the state mental health service systems, which depend very heavily on Medicaid funding. Most care for schizophrenia is delivered through these systems [5].…”

Section: Introductionmentioning

confidence: 99%

“…Within schizophrenia treatment, the rapid increase in use of the newer medications and a decrease in use of psychiatric hospitalizations [5] have combined to produce a disproportionate increase in the pharmacy budget. As a result, there is increased examination of the value provided by the more expensive medications.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Olanzapine, Risperidone, or Haloperidol on the Cost of Schizophrenia Care in a Medicaid Population

et al. 2004

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Total costs of schizophrenia care associated with olanzapine, risperidone, or haloperidol were similar, but component costs differed. Relative to risperidone or haloperidol, olanzapine may have a higher acquisition cost, but may decrease inpatient costs and be associated with more optimal medication use patterns. Use of risperidone may also increase pharmacy costs and be associated with greater persistence, relative to haloperidol.

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Perspective: Public-Sector Mental Health Care: New Challenges

Cited by 14 publications

References 10 publications

The Effect of a Medicaid Managed Care Program on Patterns of Psychiatric Readmission Among Adolescents: Evidence from Maryland

The Effect of a Medicaid Managed Care Program on Patterns of Psychiatric Readmission Among Adolescents: Evidence from Maryland

The Relationship of Antipsychotic Medication Class and Adherence with Treatment Outcomes and Costs for Florida Medicaid Beneficiaries with Schizophrenia

The Impact of Olanzapine, Risperidone, or Haloperidol on the Cost of Schizophrenia Care in a Medicaid Population

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