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Racial and Ethnic Disparities in Health Care Access and Utilization among Medicaid Managed Care Beneficiaries

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Abstract

This quasi-experimental study examined the impact of a statewide integrated special needs program Health and Recovery Plan (HARP) for individuals with serious mental illness and identified racial and ethnic disparities in access to Medicaid services. Generalized estimating equation negative binomial models were used to estimate changes in service use, difference-in-differences, and difference-in-difference-in-differences in the pre- to post-HARP periods. Implementation of the special needs plan contributed to reductions in racial/ethnic disparities in access and utilization. Notable among those enrolled in the special needs plan was the declining Black–White disparities in emergency room (ER) visits and inpatient stays, but the disparity in non-behavioral health clinic visits remains. Also, the decline of Hispanic–White disparities in ER, inpatient, and clinic use was more evident for HARP-enrolled patients. Health equity policies are needed in the delivery of care to linguistically and culturally disadvantaged Medicaid beneficiaries.

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Authors and Affiliations

  1. New York State Office of Mental Health, New York, NY, USA

    Eric Y. Frimpong PhD, MA, Wahida Ferdousi PhD, Grace A. Rowan PhD, MS, Sahil Chaudhry MS, Hannah Swetnam MS, Thomas E. Smith MD & Marleen Radigan DrPH, MS

  2. Department of Psychiatry, Columbia University Vagelos College of Physicians & Surgeons, New York, NY, USA

    Michael T. Compton MD, MPH & Thomas E. Smith MD

  3. New York State Psychiatric Institute, New York, NY, USA

    Michael T. Compton MD, MPH

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  1. Eric Y. Frimpong PhD, MA
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  2. Wahida Ferdousi PhD
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Frimpong, E.Y., Ferdousi, W., Rowan, G.A. et al. Racial and Ethnic Disparities in Health Care Access and Utilization among Medicaid Managed Care Beneficiaries. J Behav Health Serv Res 50, 194–213 (2023). https://doi.org/10.1007/s11414-022-09811-6

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