System Integrates Medicaid Patients, Substance Abuse, MH Care
The federal Substance Abuse and Mental Health Services Administration (SAMHSA) last month released its initial findings from a pilot project to integrate data from state-supported mental health service agencies, substance abuse treatment agencies, and Medicaid.
Participating States
Three states participated in the project, conducted by the Center for Substance Abuse Treatment (CSAT) and Center for Mental Health Services (CMHS), to track mental health and substance abuse patients, their use of services, and levels of expenditures.
“This study represents an important advance in health services management,” said Joseph H. Autry, M.D., acting administrator of SAMHSA. “We now have a more complete picture of the clients seen and services needed in state-supported care. It also provides us with a tool that can assess the impact of initiatives, such as policy changes that affect the delivery of care.”
The Integrated Data Base Project (IDB) compiled data from Delaware, Oklahoma, and Washington. The preliminary report, released at a SAMHSA press conference last month, contains data only from 1996; however, analysis is being completed on data from 1997 and 1998 as well.
Treatment Received
Overall, about 4 percent of the population in each of the three initial states was reportedly treated for some sort of psychiatric and/or substance abuse disorder during 1996 by a state-supported mental health and/or substance abuse agency, or a Medicaid-funded agency.
The overwhelming majority of patients—68 percent—received mental health services only, 21 percent received substance abuse services only, and 11 percent received both.
Although significant variation was evident, many patients who received care for a mental illness did so only through the Medicaid program, ranging from 26 percent to 52 percent across the three states. Patients receiving treatment for substance abuse were cared for largely by state-supported substance abuse agencies, ranging from 65 percent to 97 percent across the three states.
Clients with comorbid mental health and substance abuse disorders were more likely to receive care from the mental health and substance abuse agencies than through Medicaid. Those receiving care through state-supported agencies primarily received their care from a combination of both mental health and substance abuse agencies, while the minority received all care from mental health agencies only.
“Lessons that we learn from integrating data may be transferable to other states,” said H. Westley Clark, M.D., J.D., M.P.H., director of CSAT, “and may also facilitate the integration of data from other service systems that provide care, such as primary health care and correctional, housing, and other social services.”
Clark told those attending the press conference that such a comprehensive compilation of data on utilization would be valuable in planning for future trends.
CMHS Director Bernard S. Arons, M.D., agreed. “We need to know which public entities are purchasing mental health and substance abuse treatment services. Only with this information will we be able to determine how to coordinate services in order to use our resources to serve more individuals.”
Other states are invited to integrate their own mental health and substance abuse–related data into the growing IDB. State regulators interested in doing so can find technical information on the project’s Web site at www.samhsa.gov/centers/csat/content/idbse/index/htm.
The project’s preliminary report, “Mental Health and Substance Abuse Treatment: Results From a Study Integrating Data From State Mental Health, Substance Abuse, and Medicaid Agencies,” is available from the SAMHSA Clearinghouse on Alcohol and Drug Information by calling (800) 729-6686. It can also be downloaded from the SAMHSA Web site at www.samhsa.gov/centers/csat/content/idbse/linkrpt.asp. ▪
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Published online: 21 September 2001
Published in print: September 21, 2001
Notes
An integrated database in three states links data from publicly funded mental health and substance abuse agencies with Medicaid services, allowing a first-time look at individual use of services across the three systems.
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