Abstract
Mental health care is a critical component of Medicaid for children. This study used summary tables drawn from the 1999 Medicaid Analytic Extract (MAX) files, the first available Medicaid data for the entire US, to examine fee-for-service Medicaid in 23 selected states. Data show that 9% of children and youth (ages 0–21) had a mental health-related diagnosis on a claim, varying from 5% to 17% across the states. The proportion increased with age, and was higher for boys. Over half of those diagnosed received psychotropic medication, and approximately 7% had an inpatient psychiatric admission during the year. Mental health costs accounted for 26.5% of total fee-for-service Medicaid expenditures, varying from 14% to 61% depending on the state.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Notes
Information on the criteria used, and assigned scores for all 50 states, can be found in the “Background and Table Descriptions” section of the report, Mental Health Services in Medicaid, 1999, which can be accessed at: http://mentalhealth.samhsa.gov/publications/allpubs/sma06-4145.
Service types included in this analysis were limited to those included in the MAX summary tables.
References
Baugh, D. K., Pine, P. L., Blackwell, S., & Ciborowski, G. (2004). Medicaid spending and utilization for central nervous system drugs. Health Care Financing Review, 26, 57–73.
Buck, J. (2003). Medicaid, health care financing trends, and the future of state-based public mental health services. Psychiatric Services, 54, 969–975.
Buck, J. A., Teich, J. L., Bae, J., & Dilonardo, J. (2001). Mental health and substance abuse services in ten state Medicaid programs. Administration and Policy In Mental Health, 28, 181–192.
Cook, J. A., Heflinger, C. A., Hoven, C. W., Kelleher, K. J., Mulkern, V., Paulson, R. I., Stein-Seroussi, A., Fitzgibbon, G., Burke-Miller, J., Williams, M., & Kim, J. B. (2004). A multi-site study of Medicaid-funded managed care versus fee-for-service plan’s effects on mental health service utilization of children with severe emotional disturbance. Journal of Behavioral Health Services and Research, 31, 384–402.
Dougherty Management Associates, Inc. (2005). Children’s mental health benchmarking project: Fourth year report.
Furman, R., & Jackson, R. (2002). Wrap-around services: An analysis of community-based mental health services for children. Journal of Child and Adolescent Psychiatric Nursing, 15(3), 124–131.
Larson, M. J., Miller, K., Shyamal, S., & Manderscheid, R. (2004). Children’s mental health services in fee-for-service Medicaid. Health Care Financing Review, 26, 5–22.
Mandell, D. S., Boothroyd, R. A., & Stiles, P. G. (2003). Children’s use of mental health services in different Medicaid insurance plans. Journal of Behavioral Health Services and Research, 3, 228–237.
Mark, T. L., Buck, J. A., Dilonardo, J. D., et al. (2003). Medicaid expenditures on behavioral health care. Psychiatric Services, 54, 188–194.
National Center for Health Statistics. (2002). Health, United States, 2002. Hyattsville, Maryland.
Ringel, J. S., & Sturm, R. (2001). National estimates of mental health utilization and expenditures for children in 1998. Journal of Behavioral Health Services and Research, 28(3), 319–333.
Robinson, G., Kaye, N., Bergman, D., Moreaux, M., & Baxter, C. (2005). State profiles of mental health and substance abuse services in Medicaid. Accessible through: http://mentalhealth.samhsa.gov/publications/allpubs/State_Med/default.asp. Rockville: Center for Mental health Services, Substance Abuse and Mental Health Services Administration.
Saunders, R. C., & Heflinger, C. A. (2004). Effects of managed care on southern youths’ behavioral services use. Health Care Financing Review, 26, 23–41.
Sing, M. (2004). Using encounter data from Medicaid HMOs for research and monitoring. Inquiry 2004 Fall, 41(3), 336–346.
Sturm, R., & Andreyeva, T. (2005). Use of mental health care among youths in 1997 and 2002. Psychiatric Services, 56, 793.
Sturm, R., Ringel, J. S., & Andreyeva, T. (2003). Geographic disparities in children’s mental health care. Pediatrics, 112, e308–e315.
Teich, J. L., Buck, J. A., Graver, L., Schroeder, D., & Zheng, D. (2003). Utilization of public mental health services by children with serious emotional disturbances. Administration and Policy in Mental Health, 30, 523–534.
Verdier, J., et al. (2006). Mental health services in Medicaid, 1999. Rockville: Substance Abuse and Mental Health Services Administration. Publication No. (SMA) 06-4145.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Howell, E.M., Teich, J. Variations in Medicaid Mental Health Service Use and Cost for Children . Adm Policy Ment Health 35, 220–228 (2008). https://doi.org/10.1007/s10488-008-0163-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10488-008-0163-1