Medicaid Managed Care and the Unmet Need for Mental Health Care among Children with Special Health Care Needs
- 29 November 2007
- journal article
- Published by Wiley in Health Services Research
- Vol. 43 (3), 882-900
- https://doi.org/10.1111/j.1475-6773.2007.00811.x
Abstract
To determine the association between Medicaid managed care pediatric behavioral health programs and unmet need for mental health care among children with special health care needs (CSHCN). The National Survey of CSHCN (2000-2002), using subsets of 4,400 CSHCN with Medicaid and 1,856 CSHCN with Medicaid and emotional problems. Additional state-level sources were used. Multilevel models investigated the association between managed care program type (carve-out, integrated) or fee-for-service (FFS) and reported unmet mental health care need. The National Survey of CSHCN conducted telephone interviews with a sample representative at both the national and state levels. In multivariable models, among CSHCN with only Medicaid, living in states with Medicaid managed care (odds ratio [OR]=1.81; 95 percent confidence interval: 1.04-3.15) or carve-out programs (OR=1.93; 1.01-3.69) were associated with greater reported unmet mental health care need compared with FFS programs. Among CSHCN on Medicaid with emotional problems, the association between managed care and unmet need was stronger (OR=2.48; 1.38-4.45). State Medicaid pediatric behavioral health managed care programs were associated with greater reported unmet mental health care need than FFS programs among CSHCN insured by Medicaid, particularly for those with emotional problems.Keywords
This publication has 32 references indexed in Scilit:
- The Effects of Health Sector Market Factors and Vulnerable Group Membership on Access to Alcohol, Drug, and Mental Health CareHealth Services Research, 2006
- Mental Health Care Services for Children With Special Health Care Needs and Their Family Members: Prevalence and Correlates of Unmet NeedsPediatrics, 2006
- Medicaid Managed Care and Health Care for ChildrenHealth Services Research, 2005
- Incentives in a Medicaid Carve-Out: Impact on Children with Special Health Care NeedsHealth Services Research, 2005
- Do Children Receiving Supplemental Security Income Who Are Enrolled in Medicaid Fare Better Under a Fee-for-Service or Comprehensive Capitation Model?Pediatrics, 2004
- Managed Care Organizational Characteristics and Health Care Use among Children with Special Health Care NeedsHealth Services Research, 2003
- State Health Care Reform: Behavioral Health Services Under Medicaid Managed Care: The Uncertain Implications of State VariationPsychiatric Services, 2001
- Perspective: Competing Interests: Public-Sector Managed Behavioral Health CareHealth Affairs, 1999
- Correlates of unmet need for mental health services by children and adolescentsPsychological Medicine, 1997
- Depression Among Children with Chronic Medical Problems: A Meta-AnalysisJournal of Pediatric Psychology, 1994