Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Factors Associated with Geographic Variation in Psychiatric Prescription Drug Expenditures Among Medicaid Beneficiaries

This is a preview of subscription content, log in to check access.

References

  1. 1.

    Frank RG, Goldman HH, McGuire TG. Trends in mental health cost growth: an expanded role for management? Health Affairs. 2009;28(3):649–659..

  2. 2.

    Frank RG, Conti RM, Goldman HH. Mental health policy and psychotropic drugs. Milbank Quarterly. 2005;83(2):271–298.

  3. 3.

    Keith S. Advances in psychotropic formulations. Progress in Neuropsychopharmacology & Biological Psychiatry. 2006;30(6):996–1008.

  4. 4.

    Mojtabai R. Americans’ attitudes toward psychiatric medications: 1998–2006. Psychiatric Services 2009;60(8):1015–1023.

  5. 5.

    Kessler RC, Heeringa S, Lakoma MD, et al. Individual and societal effects of mental disorders on earnings in the United States: results from the national comorbidity survey replication. American Journal of Psychiatry. 2008;165(6):703–711.

  6. 6.

    Garfield RL, Zuvekas SH, Lave JR, et al. The impact of national health care reform on adults with severe mental disorders. American Journal of Psychiatry. 2011;168(5):486–494.

  7. 7.

    Saraceno B, Levav I, Kohn R. The public mental health significance of research on socio-economic factors in schizophrenia and major depression. World Psychiatry. 2005;4(3):181–185.

  8. 8.

    Sareen J, Afifi TO, McMillan KA, et al. Relationship between household income and mental disorders: findings from a population-based longitudinal study. Archives of General Psychiatry. 2011;68(4):419–427.

  9. 9.

    Cunningham PJ. Medicaid cost containment and access to prescription drugs. Health Affairs. 2005;24(3):780–789.

  10. 10.

    Fortess EE, Soumerai SB, McLaughlin TJ, et al. Utilization of essential medications by vulnerable older people after a drug benefit cap: importance of mental disorders, chronic pain, and practice setting. Journal of the American Geriatrics Societ. 2001;49(6):793–797.

  11. 11.

    Bishop TF, Press MJ, Keyhani S, Pincus H. Acceptance of insurance by psychiatrists and the implications for access to mental health care. Journal of the American Medical Association Psychiatry. 2014;71(2):176–181.

  12. 12.

    Decker SL. Two-thirds of primary care physicians accepted new Medicaid patients in 2011–12: a baseline to measure future acceptance rates. Health Affairs. 2013;32(7):1183–1187.

  13. 13.

    Levinson D. Access to Care: Provider Availability in Medicaid Managed Care. Washington, DC: Office of the Inspector General, Department of Health and Human Services; 2014. Available online at http://oig.hhs.gov/oei/reports/oei-02-13-00670.pdf.

  14. 14.

    Health Resources and Services Administration. What Are Rural Health Clinics (RHCs)?. Washington, DC: U.S. Department of Health and Human Services Available online at http://www.hrsa.gov/healthit/toolbox/RuralHealthITtoolbox/Introduction/ruralclinics.html.

  15. 15.

    Health Resources and Services Administration. Primary Care: The Health Center Program. U.S. Department of Health and Human Services Available online at http://bphc.hrsa.gov/about/index.html. Accessed August 23, 2013.

  16. 16.

    Jones E, Ku L, Smith S, Lardiere M. County Workforce, Reimbursement, and Organizational Factors Associated with Behavioral Health Capacity in Health Centers. Journal of Behavioral Health Services & Research. 2013.

  17. 17.

    Centers or Medicare and Medicaid Services. Rural Health Clinic. Washington, DC: US Department of Health and Human Services; 2014. Available online at http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/RuralHlthClinfctsht.pdf.

  18. 18.

    Soumerai SB, Ross-Degnan D, Avorn J, et al. Effects of Medicaid drug-payment limits on admission to hospitals and nursing homes. New England Journal of Medicine. 1991;325(15):1072–1077.

  19. 19.

    Soumerai S. Unintended outcomes of Medicaid drug cost-containment policies on the chronically mentally ill. Journal of Clinical Psychiatry. 2003;64 Suppl 17:19–22.

  20. 20.

    Horvitz-Lennon M, Normand SL, Gaccione P, et al. Partial versus full hospitalization for adults in psychiatric distress: a systematic review of the published literature (1957–1997). American Journal of Psychiatry. 2001;158(5):676–685.

  21. 21.

    National Alliance on Mental Illness. Medicaid Facts - What You Need to Know. Arlington, VA; 2003. Available online at http://www.nami.org/Content/NavigationMenu/Inform_Yourself/About_Public_Policy/Policy_Research_Institute/NAMI-Medicaid_Facts.pdf.

  22. 22.

    Gilmer TP, Kronick RG. Differences In The Volume Of Services And In Prices Drive Big Variations In Medicaid Spending Among US States And Regions. Health Affairs. 2011;30(7):1316–1324.

  23. 23.

    Centers for Medicare and Medicaid Services. Medicaid Statistical Information System (MSIS) State Summary Datamarts. Available online at http://www.cms.gov/Research-Statistics-Data-and-Systems/Computer-Data-and-Systems/MedicaidDataSourcesGenInfo/MSIS-Mart-Home.html.

  24. 24.

    Henning-Smith C, McAlpine D, Shippee T, et al. Delayed and unmet need for medical care among publicly insured adults with disabilities. Medical Care. 2013;51(11):1015–1019.

  25. 25.

    Urban Institute. Medicaid Atlas of Health Care: Mental Health Care.; 2012.

  26. 26.

    Health Resources and Services Administration. Area Health Resources File. U.S. Department of Health and Human Services. Available online at http://ahrf.hrsa.gov/index.htm.

  27. 27.

    Wennberg DE, Cooper M, Bubolz, TA, et al. The Dartmouth Atlas of Health Care. Chicago: American Hospital Association, 1996.

  28. 28.

    Kronick R, Gilmer T, Dreyfus T, et al. Improving health-based payment for Medicaid beneficiaries: CDPS. Health Care Financing Review. 2000;21(3):29–64.

  29. 29.

    StataCorp. Stata Statistical Software: Release 12. College Station, TX: StataCorp LP; 2011.

  30. 30.

    Health Resources and Services Administration. 340 Drug Pricing Program & Pharmacy Affairs. U.S. Department of Health and Human Services Available online at http://www.hrsa.gov/opa/.

  31. 31.

    Health Resources and Services Administration. 340B Drug Pricing Program: Eligibility & Registration. U.S. Department of Health and Human Services Available online at http://www.hrsa.gov/opa/eligibilityandregistration/index.html.

  32. 32.

    Health Resources and Services Administration. 2012 National Data. Available online at http://bphc.hrsa.gov/uds/datacenter.aspx?year=2012.

  33. 33.

    Health Resources and Services Administration. Authorizing Legislation of the Health Center Program Section 330 of the Public Health Service Act (42 USCS § 254b). Available online at http://bphc.hrsa.gov/policiesregulations/legislation/authorizing330.pdf.

  34. 34.

    The Henry J. Kaiser Family Foundation. 5 Key Questions about Medicaid and Is Role in State/federal Budgets & Health Reform. Washington, DC; 2012. Available online at http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8139-02.pdf.

  35. 35.

    Connolly J, Paradise J. People with Disabilities and Medicaid Managed Care: Key Lessons to Consider. Washington, DC: The Henry J. Kaiser Family Foundation; 2012. Available online at http://kaiserfamilyfoundation.files.wordpress.com/2013/01/8278.pdf.

  36. 36.

    Baicker K, Taubman SL, Allen HL, et al. The Oregon experiment--effects of Medicaid on clinical outcomes. New England Journal of Medicine. 2013;368(18):1713–1722.

  37. 37.

    Sommers BD, Baicker K, Epstein AM. Mortality and access to care among adults after state Medicaid expansions. New England Journal of Medicine. 2012;367(11):1025–1034.

  38. 38.

    Garfield RL, Lave JR, Donohue JM. Health reform and the scope of benefits for mental health and substance use disorder services. Psychiatric Services Wash DC. 2010;61(11):1081–1086.

  39. 39.

    Beronio K, Glied S, Frank R. How the Affordable Care Act and Mental Health Parity and Addiction Equity Act greatly expand coverage of behavioral health care. Journal of Behavioral Health Services & Research. 2014:1–19.

Download references

Conflict of Interest

The authors have no conflicts of interest to report.

Author information

Correspondence to Julia Zur PhD.

Additional information

This research was supported by The Urban Institute, the Office of the Assistant Secretary for Planning and Evaluation, and the RCHN Community Health Foundation.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Zur, J., Ku, L. Factors Associated with Geographic Variation in Psychiatric Prescription Drug Expenditures Among Medicaid Beneficiaries. J Behav Health Serv Res 43, 504–512 (2016). https://doi.org/10.1007/s11414-015-9471-x

Download citation

Keywords

  • Mental Health Service
  • Psychiatric Medication
  • Prescription Drug Coverage
  • Medicaid Beneficiary
  • Prescription Drug Expenditure