The Effects of Medicaid Section 1115 Serious Mental Illness Waivers on Healthcare Utilization and Suicide-Related Behaviors
医疗补助第 1115 条严重精神疾病豁免对医疗保健利用和自杀相关行为的影响
基本信息
- 批准号:10775350
- 负责人:
- 金额:$ 76.99万
- 依托单位:
- 依托单位国家:美国
- 项目类别:
- 财政年份:2023
- 资助国家:美国
- 起止时间:2023-09-20 至 2027-07-31
- 项目状态:未结题
- 来源:
- 关键词:Accident and Emergency departmentAcuteAddressAdmission activityAdolescentAdultAffectBackBedsBehaviorCaringCessation of lifeChildClinicalCommunitiesDataData SetDiseaseEconomicsElementsEligibility DeterminationEmergency CareEmotional DisturbanceEnrollmentExclusionFederal GovernmentFundingHealthHealth ServicesHomelessnessImprisonmentImprove AccessIndividualInformation SystemsInpatientsInstitutionInterviewMeasuresMedicaidMental HealthMental Health ServicesMethodsNatural experimentNeighborhoodsOutcomeOutpatientsPatient-Focused OutcomesPersonal SatisfactionPersonsPoliciesPrevalenceProcessPsyche structurePublic PolicyRaceReportingResearchResidential FacilitiesRoleServicesSuicideSuicide attemptSystemUnited States Centers for Medicare and Medicaid ServicesViolencebehavioral healthbeneficiarycare coordinationclinically significantcommunity based servicecommunity settingdata managementdesignexperiencehealth care service utilizationhospital readmissionimprovedimproved outcomeinformantinsightpaymentpsychiatric emergencypsychological distressreducing suicideresidential segregationresponsesegregationservice coordinationservice utilizationsevere mental illnesssubstance use treatmentsuicidal morbiditytreatment serviceswaiver
项目摘要
PROJECT SUMMARY
There is a growing mental health crisis in the US, with the prevalence of clinically significant psychological
distress growing while access to behavioral health services apparently worsening. There has been a
particular shortage in the availability of crisis services and inpatient beds, placing a greater burden on
emergency departments and potentially associated with higher rates of homelessness, incarceration of
persons with serious mental illness, and worse health and wellbeing. The shortage of inpatient psychiatric beds
can be tied in part to Medicaid policies that do not allow federal payment for stays in “Institutions for Mental
Diseases” (IMDs), facilities with more than 16 beds that specialize in behavioral health treatment.
Recently, the Centers for Medicare & Medicaid Services (CMS) created an opportunity for states to apply for
waivers to receive federal payments for stays in IMDs for adults with serious mental illness (SMI) and
children with serious emotional disturbances (SED). Eleven states have received an SMI/SED waiver, and
five are pending. The waivers have the potential to improve crisis care and outpatient mental health care,
potentially reducing emergency department use and boarding, improving the coordination of care, and
reducing suicide and suicide-related behaviors. However, it is not yet clear whether the waivers have led to
changes in services or what state implementations are most successful in improving outcomes.
This comprehensive mixed-methods study will assess the effects of removing the IMD exclusion through the
SMI waivers. The staggered waiver approval process creates a natural experiment to compare states that
implement the waiver to those that do not. Our quantitative analysis will use the Transformed Medicaid
Statistical Information System Analytic Files (TAF), a national Medicaid data set that includes information on
eligibility, enrollment, and claims related to service utilization and prescription use. Our qualitative analysis will
explore state-level factors that may contribute to changes in outcomes. In response to PAR-21-316, our
proposed study will identify policies and factors that affect access, utilization, and outcomes, using large
Medicaid claims datasets and leveraging an existing data management approach to advance our research.
项目总结
项目成果
期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)
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Kenneth John McConnell其他文献
Kenneth John McConnell的其他文献
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{{ truncateString('Kenneth John McConnell', 18)}}的其他基金
The Effects of Statewide Comprehensive Integrated Care for Medicaid Enrollees.
全州范围内综合综合护理对医疗补助参与者的影响。
- 批准号:
10404642 - 财政年份:2020
- 资助金额:
$ 76.99万 - 项目类别:
The Effects of Statewide Comprehensive Integrated Care for Medicaid Enrollees.
全州范围内综合综合护理对医疗补助参与者的影响。
- 批准号:
10217001 - 财政年份:2020
- 资助金额:
$ 76.99万 - 项目类别:
The Effects of Statewide Comprehensive Integrated Care for Medicaid Enrollees.
全州范围内综合综合护理对医疗补助参与者的影响。
- 批准号:
10640281 - 财政年份:2020
- 资助金额:
$ 76.99万 - 项目类别:
The Effects of Statewide Comprehensive Integrated Care for Medicaid Enrollees.
全州范围内综合综合护理对医疗补助参与者的影响。
- 批准号:
10027443 - 财政年份:2020
- 资助金额:
$ 76.99万 - 项目类别:
Assessing the Potential for a State Medicaid Reform Model to Reduce Disparities
评估国家医疗补助改革模式减少差距的潜力
- 批准号:
9329485 - 财政年份:2016
- 资助金额:
$ 76.99万 - 项目类别:
Oregon's Parity Law: Comprehensive Parity in Today's Healthcare Environment
俄勒冈州平等法:当今医疗环境中的全面平等
- 批准号:
7501317 - 财政年份:2007
- 资助金额:
$ 76.99万 - 项目类别:
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