Impact of a Usual Source of Care on Health Care Use, Spending, and Quality Among Adults With Mental Health Conditions

  • Catherine A. Fullerton
  • Whitney P. Witt
  • Clifton M. Chow
  • Manjusha Gokhale
  • Christine E. Walsh
  • Erika L. Crable
  • Sarah Naeger
Original Article


Physical comorbidities associated with mental health conditions contribute to high health care costs. This study examined the impact of having a usual source of care (USC) for physical health on health care utilization, spending, and quality for adults with a mental health condition using Medicaid administrative data. Having a USC decreased the probability of inpatient admissions and readmissions. It decreased expenditures on emergency department visits for physical health, 30-day readmissions, and behavioral health inpatient admissions. It also had a positive effect on several quality measures. Results underscore the importance of a USC for physical health and integrated care for adults with mental health conditions.


Usual source of care Spending Quality Integration Mental health conditions 



We would like to acknowledge Derek Fugh from IBM Watson Health for his programming assistance. We also acknowledge many constructive comments from the staff at SAMHSA and their federal partners and, in particular, comments and assistance from Mitchell Berger.


This research was supported by the Substance Abuse and Mental Health Services Administration (SAMHSA), U.S. Department of Health and Human Services (HHS) (SAMHSA IDIQ prime contract HHSS283200700029I, task order HHSS28342002T).

Compliance with Ethical Standards

Conflict of interest

No author has any potential conflict of interest or financial support to disclose regarding equity ownership, profit-sharing agreements, royalties, or patents; research or other grants from private industry or closely affiliated nonprofit funds; or support of any kind from pharmaceutical companies.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Catherine A. Fullerton
    • 1
  • Whitney P. Witt
    • 2
  • Clifton M. Chow
    • 1
    • 3
  • Manjusha Gokhale
    • 1
  • Christine E. Walsh
    • 2
  • Erika L. Crable
    • 1
    • 4
  • Sarah Naeger
    • 5
  1. 1.IBM Watson HealthCambridgeUSA
  2. 2.IBM Watson HealthDurhamUSA
  3. 3.Cambridge Health AllianceCambridgeUSA
  4. 4.Boston University School of Public HealthBostonUSA
  5. 5.IBM Watson HealthBethesdaUSA

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