 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Huey-Jen Chen, PhD1, Kristine Jones, PhD2, Neil Jordan, PhD3, David L. Shern, PhD1, and Roger A. Boothroyd, PhD1. (1) Louis de la Parte Florida Mental Health Institute, University of South Florida, 13301 Bruce B. Downs Blvd, Tampa, FL 33612, 813-974-7409, chen@mirage.fmhi.usf.edu, (2) Center for the Study of Issues in Public Mental Health, Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Road, Orangeburg, NY 10962, (3) Dept of Mental Health Law & Policy, University of South Florida, 13301 Bruce B Downs Blvd, Tampa, FL 33612
The presence of varying Medicaid mental health insurance plans in Florida provide a unique opportunity to examine the impact of managed care risk arrangements on cost shifting and substitutions between mental health, medical, pharmaceutical and substance abuse services as well as non-health sectors (e.g., corrections, social services, informal providers). . The presentation will summarize data from 688 adults with severe mental illness enrolled in two Medicaid managed care arrangements. Self-reported service utilization data were collected on a bi-monthly basis over a 15-month period. Information included the frequency and intensity of use of mental health, general health, pharmacy and other social services, housing, criminal justice contacts and income allowing the construction of a total social cost measure. Administrative data were used to validate and supplement these self-reports. Details on actual providers and co-payments allows for an investigation into differences among financing conditions in the overall distribution of financial burden between formal and informal providers. Last year, preliminary analyses were presented that showed a trend toward higher psychiatric inpatient, outpatient and emergency service costs; and significantly lower cost in formal off-budget mental health services for persons enrolled in a fee-for-service delivery system as compared to persons enrolled in either of two managed care arrangements. This year the final results of this social cost analysis will be presented that have been expanded to include costs associated with non-health sector involvement. The analytic modeling approach has been enhanced through the use of propensity scores to better control for selection biases across managed care arrangements.
Learning Objectives:
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.