Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system

Ramesh Raghavan, Arleen A. Leibowitz, Ronald M. Andersen, Bonnie T. Zima, Mark A. Schuster, John Landsverk

    Research output: Contribution to journalArticle

    Abstract

    Children in the child welfare system are dependent upon Medicaid to finance services for their considerable mental health needs. This study examines the effects of Medicaid policies on mental health service use among a national probability sample of children in the child welfare system. Data for this study came from the National Survey of Child and Adolescent Well-Being, the Caring for Children in Child Welfare study, and the Area Resource File. Weighted multivariate logistic regression analyses were conducted to estimate effects of policy variables on children's use of mental health services, controlling for child-level covariates and county-level health resources. Children in counties with behavioral carve-outs under Medicaid managed care had lower odds of inpatient mental health service use. Medicaid managed care enrollment and variations in type of provider reimbursement did not affect use of mental health services. Older age, greater need for mental health services, and higher levels of caregiver education were associated with increased odds of service use. Restrictions on use of inpatient mental healthcare caused by behavioral carve-outs may disproportionately affect children in the child welfare system who have high rates of such use. Careful adoption of carve-outs is necessary to assure appropriate care for these children.

    Original languageEnglish (US)
    Pages (from-to)1482-1496
    Number of pages15
    JournalChildren and Youth Services Review
    Volume28
    Issue number12
    DOIs
    StatePublished - Dec 1 2006

    Fingerprint

    Sampling Studies
    Medicaid
    Mental Health Services
    Managed Care Programs
    Child Welfare
    child welfare
    managed care
    health service
    mental health
    Inpatients
    Health Resources
    Child Care
    Caregivers
    Health Status
    Mental Health
    Logistic Models
    resources
    Regression Analysis
    caregiver
    Delivery of Health Care

    Keywords

    • Carve-out
    • Child welfare
    • Children
    • Medicaid
    • Mental health

    ASJC Scopus subject areas

    • Education
    • Developmental and Educational Psychology
    • Sociology and Political Science

    Cite this

    Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system. / Raghavan, Ramesh; Leibowitz, Arleen A.; Andersen, Ronald M.; Zima, Bonnie T.; Schuster, Mark A.; Landsverk, John.

    In: Children and Youth Services Review, Vol. 28, No. 12, 01.12.2006, p. 1482-1496.

    Research output: Contribution to journalArticle

    Raghavan, Ramesh ; Leibowitz, Arleen A. ; Andersen, Ronald M. ; Zima, Bonnie T. ; Schuster, Mark A. ; Landsverk, John. / Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system. In: Children and Youth Services Review. 2006 ; Vol. 28, No. 12. pp. 1482-1496.
    @article{d33aba35527f4e0b8cded021a0ea7ec7,
    title = "Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system",
    abstract = "Children in the child welfare system are dependent upon Medicaid to finance services for their considerable mental health needs. This study examines the effects of Medicaid policies on mental health service use among a national probability sample of children in the child welfare system. Data for this study came from the National Survey of Child and Adolescent Well-Being, the Caring for Children in Child Welfare study, and the Area Resource File. Weighted multivariate logistic regression analyses were conducted to estimate effects of policy variables on children's use of mental health services, controlling for child-level covariates and county-level health resources. Children in counties with behavioral carve-outs under Medicaid managed care had lower odds of inpatient mental health service use. Medicaid managed care enrollment and variations in type of provider reimbursement did not affect use of mental health services. Older age, greater need for mental health services, and higher levels of caregiver education were associated with increased odds of service use. Restrictions on use of inpatient mental healthcare caused by behavioral carve-outs may disproportionately affect children in the child welfare system who have high rates of such use. Careful adoption of carve-outs is necessary to assure appropriate care for these children.",
    keywords = "Carve-out, Child welfare, Children, Medicaid, Mental health",
    author = "Ramesh Raghavan and Leibowitz, {Arleen A.} and Andersen, {Ronald M.} and Zima, {Bonnie T.} and Schuster, {Mark A.} and John Landsverk",
    year = "2006",
    month = "12",
    day = "1",
    doi = "10.1016/j.childyouth.2006.04.001",
    language = "English (US)",
    volume = "28",
    pages = "1482--1496",
    journal = "Children and Youth Services Review",
    issn = "0190-7409",
    publisher = "Elsevier Limited",
    number = "12",

    }

    TY - JOUR

    T1 - Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system

    AU - Raghavan, Ramesh

    AU - Leibowitz, Arleen A.

    AU - Andersen, Ronald M.

    AU - Zima, Bonnie T.

    AU - Schuster, Mark A.

    AU - Landsverk, John

    PY - 2006/12/1

    Y1 - 2006/12/1

    N2 - Children in the child welfare system are dependent upon Medicaid to finance services for their considerable mental health needs. This study examines the effects of Medicaid policies on mental health service use among a national probability sample of children in the child welfare system. Data for this study came from the National Survey of Child and Adolescent Well-Being, the Caring for Children in Child Welfare study, and the Area Resource File. Weighted multivariate logistic regression analyses were conducted to estimate effects of policy variables on children's use of mental health services, controlling for child-level covariates and county-level health resources. Children in counties with behavioral carve-outs under Medicaid managed care had lower odds of inpatient mental health service use. Medicaid managed care enrollment and variations in type of provider reimbursement did not affect use of mental health services. Older age, greater need for mental health services, and higher levels of caregiver education were associated with increased odds of service use. Restrictions on use of inpatient mental healthcare caused by behavioral carve-outs may disproportionately affect children in the child welfare system who have high rates of such use. Careful adoption of carve-outs is necessary to assure appropriate care for these children.

    AB - Children in the child welfare system are dependent upon Medicaid to finance services for their considerable mental health needs. This study examines the effects of Medicaid policies on mental health service use among a national probability sample of children in the child welfare system. Data for this study came from the National Survey of Child and Adolescent Well-Being, the Caring for Children in Child Welfare study, and the Area Resource File. Weighted multivariate logistic regression analyses were conducted to estimate effects of policy variables on children's use of mental health services, controlling for child-level covariates and county-level health resources. Children in counties with behavioral carve-outs under Medicaid managed care had lower odds of inpatient mental health service use. Medicaid managed care enrollment and variations in type of provider reimbursement did not affect use of mental health services. Older age, greater need for mental health services, and higher levels of caregiver education were associated with increased odds of service use. Restrictions on use of inpatient mental healthcare caused by behavioral carve-outs may disproportionately affect children in the child welfare system who have high rates of such use. Careful adoption of carve-outs is necessary to assure appropriate care for these children.

    KW - Carve-out

    KW - Child welfare

    KW - Children

    KW - Medicaid

    KW - Mental health

    UR - http://www.scopus.com/inward/record.url?scp=33750191778&partnerID=8YFLogxK

    UR - http://www.scopus.com/inward/citedby.url?scp=33750191778&partnerID=8YFLogxK

    U2 - 10.1016/j.childyouth.2006.04.001

    DO - 10.1016/j.childyouth.2006.04.001

    M3 - Article

    AN - SCOPUS:33750191778

    VL - 28

    SP - 1482

    EP - 1496

    JO - Children and Youth Services Review

    JF - Children and Youth Services Review

    SN - 0190-7409

    IS - 12

    ER -