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Integrated care models and behavioral health care utilization: Quasi‐experimental evidence from Medicaid health homes
Author(s) -
McClellan Chandler,
Maclean Johanna Catherine,
Saloner Brendan,
McGinty Emma E.,
Pesko Michael F.
Publication year - 2020
Publication title -
health economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.55
H-Index - 109
eISSN - 1099-1050
pISSN - 1057-9230
DOI - 10.1002/hec.4027
Subject(s) - medicaid , health care , medicine , public health , mental health , population , family medicine , environmental health , psychiatry , gerontology , nursing , economics , economic growth
Integration of behavioral and general medical care can improve outcomes for individuals with behavioral health conditions—serious mental illness (SMI) and substance use disorder (SUD). However, behavioral health care has historically been segregated from general medical care in many countries. We provide the first population‐level evidence on the effects of Medicaid health homes (HH) on behavioral health care service use. Medicaid, a public insurance program in the United States, HHs were created under the 2010 Affordable Care Act to coordinate behavioral and general medical care for enrollees with behavioral health conditions. As of 2016, 16 states had adopted an HH for enrollees with SMI and/or SUD. We use data from the National Survey on Drug Use and Health over the period 2010 to 2016 coupled with a two‐way fixed‐effects model to estimate HH effects on behavioral health care utilization. We find that HH adoption increases service use among enrollees, although mental health care treatment findings are sensitive to specification. Further, enrollee self‐reported health improves post‐HH.