MANAGEMENT UPDATE.

MEDICAID AND MENTAL HEALTH CARE: STATE BY STATE

About one in four adults in the United States suffer from some sort of mental health issues, according to the Substance Abuse and Mental Health Services Administration (SAMSHA) . A disproportionate share of this population are people who are enrolled in the Medicaid program. In fact, according to SAMSHA, over one in three adults whose health care is covered by Medicaid have had to deal with some form of mental illness.

Though the federal government makes a significant contribution to Medicaid, the states contribute, as well, at different rates and administer the programs. “As a result,” according to a report by Addiction-rep, which is a consulting firm that specializes in the behavioral health arena, “the availability and quality of behavioral health services can vary significantly from state to state. These differences are especially important now, as many states face financial pressures and potential budget cuts that could make it harder for people to access the care they need.”

According to the report, Addiction-rep assembled an index to compare the quality with which the state Medicaid programs deliver mental health care.

It ranked states on four categories;

Initiation and engagement
Evidence-based medication use
Care continuity and follow-up
Patient experience.

The top ten states in the list were largely in New England, with New Hampshire, Massachusetts and Vermont ranking first second and third. That may not be a big surprise, but a few of the states that made the top ten were slightly less predictable, including West Virginia (which ranked fourth) and Kentucky (seventh).

At the other end of the spectrum, “Several large and populous states landed near the bottom of the rankings. California, Texas, Illinois, and Georgia all appeared in the bottom 10, along with states like Arkansas and Oklahoma. California stood out for its strong performance in the use of evidence-based medications and follow-up care after behavioral health episodes, but it scored poorly on treatment initiation and patient experience—pulling down its overall ranking. Other lower-performing states tended to show more consistently weak results.”