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

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Abstract

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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Acknowledgments

This work was supported by grants from the Center for Health Care Strategies, Inc., under the Annie E. Casey Foundation’s Children In Managed Care Initiative (CIMC), the Thomas Wilson Sanitarium for Children of Baltimore City, and the Baltimore Community Foundation. The authors gratefully acknowledge the support and assistance of Tom Merrick and Robin Jacobs from the Mental Hygiene Administration of the Maryland Department of Health and Mental Hygiene, Patty Hesse from Maryland Health Partners, and Jayne May Miller and Babi Lamba from the Center for Health Program Development and Management, UMBC.

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Correspondence to Cynthia A. Fontanella PhD.

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Cynthia A. Fontanella, PhD, is a postdoctoral fellow at Institute for Health, Health Care Policy, and Aging Research (IHHCPAR), Rutgers University, 30 College Avenue, New Brunswick, NJ 08901 USA.

Susan J. Zuravin, PhD, is a professor at University of Maryland School of Social Work, 525 West Redwood Street, Baltimore, MD 21201 USA.

Caroline L. Burry, PhD, is a associate professor at University of Maryland School of Social Work, 525 West Redwood Street, Baltimore, MD 21201 USA.

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Fontanella, C.A., Zuravin, S.J. & Burry, C.L. The Effect of a Medicaid Managed Care Program on Patterns of Psychiatric Readmission Among Adolescents: Evidence from Maryland. JBHSR 33, 39–52 (2006). https://doi.org/10.1007/s11414-005-9004-0

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