Geographic variations in use of Medicaid mental health services.
Ezra Golberstein, Taeho Greg Rhee, Thomas G McGuire
Author Information
Ezra Golberstein: Dr. Golberstein and Mr. Rhee are with the Department of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis (e-mail: egolber@umn.edu ). Dr. McGuire is with the Department of Health Care Policy, Harvard Medical School, Boston. Steven S. Sharfstein, M.D., Haiden A. Huskamp, Ph.D., and Alison Evans Cuellar, Ph.D., are editors of this column.
An extensive literature documents geographic variations in patterns of health services use and spending but virtually ignores mental health services. The authors assessed geographic variations in use of and spending on mental health services among adult disabled Medicaid recipients with mental illness. Data were derived from 2008 Medicaid claims in 35 states. Per capita annual inpatient days, ambulatory visits, psychotropic medication fills, and spending on psychiatric services varied widely across regions. The proportion of total variation explained by interstate differences ranged from 43% (inpatient days) to 71% (ambulatory visits). Understanding these variations more thoroughly may help improve the effectiveness and efficiency of mental health services delivered under Medicaid.
