Utilization of acute inpatient psychiatric services: “Heavy users” in New York State

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The severely and persistently mentally ill (SPMI) population are often forced to rely on emergency/acute inpatient services. The authors analyze Medicaid expenditures and state hospital utilization data to identify and describe the characteristics of “heavy users” of these services. Also described is New York State's intensive case management (ICM) initiative targeted at this “heavy user” group. It is postulated that ICM will alter the utilization patterns of participants from over-reliance on the most costly services and more effectively and efficiently serve the SPMI population, specifically the “heavy user” subpopulation.