Geography and the Medicaid Mental Health Care Infrastructure

Cummings, Janet R.; Wen, Hefei; Ko, Michelle J; Druss, Benjamin G.

doi:10.1001/jamapsychiatry.2013.377

Cited by 73 publications

(73 citation statements)

References 21 publications

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“…Another policy option includes expanding SUD treatment capacity in safety-net facilities that provide MH services in these counties, because many facilities that focus on MH outpatient services do not routinely provide SUD services. However, a recent study reported that counties with a high percentage of Black residents are also less likely to offer access to an outpatient MH treatment facility that serves Medicaid enrollees; 17 therefore, although expansion of SUD treatment services via the MH safety net may improve overall access to care, it may not reduce the disparities for Black communities.…”

Section: Discussionmentioning

confidence: 99%

“…Although the annual prevalence of SUDs is similar across White (9.0 percent), Black (8.8 percent), and Hispanic (9.5 percent) populations, 14 prior studies have found that Blacks and Hispanics are less likely to receive substance use services relative to Whites. 11,15,16 Researchers have speculated that differences in geographic access to the treatment system could partially explain these lower rates of use for racial/ethnic minorities, and an emerging body of research has found that access to other elements of the healthcare infrastructure is worse (e.g., physician shortages and access to specialty MH facilities) 17,18 and more likely to deteriorate (e.g., closures of hospitals and trauma centers) 19,20 in communities of color.…”

Section: Introductionmentioning

confidence: 99%

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Race/Ethnicity and Geographic Access to Medicaid Substance Use Disorder Treatment Facilities in the United States

et al. 2014

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Race/Ethnicity and Geographic Access to Medicaid Substance Use Disorder Treatment Facilities in the United States

et al. 2014

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“…This knowledge gap warrants particular attention because most government authority to address BH issues exists at the state-level. State policy makers, for example, determine the types of BH services that are reimbursable through Medicaid—the largest payer of BH services in the US (31–32). Federal legislation has attempted to promote BH insurance parity (33), but state legislation is needed to supplement federal laws and ensure equal coverage (34–35).…”

mentioning

confidence: 99%

Uses of Research Evidence by State Legislators Who Prioritize Behavioral Health Issues

Purtle¹,

Dodson²,

Brownson³

2016

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Objective Disseminating behavioral health (BH) research to legislators (i.e., elected policy makers) is widely acknowledged as a priority, but little is known about how research evidence is used and sought by this audience. The primary aim of this exploratory study was to identify the research dissemination preferences and research seeking practices of legislators who prioritize BH issues and describe the role research plays in determining their policy priorities. The secondary aim was to assess if these legislators differ from legislators who do not prioritize BH issues. Methods A telephone-based survey was conducted with 862 US state legislators (response rate 50%). A validated survey instrument was used to assess legislators’ priorities and the factors that determine them, research dissemination preferences, and research seeking practices. Bivariate analyses were conducted to characterize the study population and compare legislators who prioritized BH issues to legislators who did not. Results Legislators who prioritized BH issues were significantly more likely to identify research evidence as a factor that determined policy priorities than legislators who did not prioritize these issues (odds ratio=1.91, 95% CI=1.25–2.90, p=.002). Legislators who prioritized BH issues also attributed more importance to 10-of-12 features of disseminated research (e.g., research being unbiased [p=.014], research telling a story [p=.033]) and engaged in 8-of-11 research seeking and utilization practices (e.g., attending research presentations [p=.012]) more often. Conclusions Legislators who prioritize BH issues actively seek, have distinct preferences for, and are particularly influenced by research evidence. Testing legislator-focused BH research dissemination strategies is an area for future research.

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“…However, there is no reason to believe that differences in the response rates would have biased the findings associated with the trends in ownership mix or the geographic availability of facilities across racial minority communities. Finally, although the county is a meaningful unit of analysis for health resource planning purposes and has been used to understand the distribution of outpatient health care resources for vulnerable populations (25, 26), future research should examine the geographic availability of facilities using smaller units of analysis as data become available.…”

Section: Study Data and Methodsmentioning

confidence: 99%

Decline In Public Substance Use Disorder Treatment Centers Most Serious In Counties With High Shares Of Black Residents

Cummings

Wen

2016

Health Affairs

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We used data from the 2002 to 2010 National Survey of Substance Abuse Treatment Services to describe changes in the supply of public and private outpatient substance use treatment facilities, and whether these trends had implications for the geographic availability of this infrastructure in racial minority counties. Between 2002 and 2010, the number of publicly owned facilities declined 17.2 percent, whereas number of private, for-profit facilities grew 19.1 percent. At baseline, counties with a very high percentage of black residents (i.e., more than one standard deviation above the mean) were more likely (p<0.01) than counties with less than the mean percentage of black residents to be served by public facilities and were thus disproportionately affected by the overall decline in the public sector. Furthermore, the public sector losses in these counties were not offset by an increased likelihood in gains in private for-profit or nonprofit facilities. Future research should examine the effect of Medicaid expansions on the supply of substance use treatment facilities, with particular attention to counties with a high percentage of black residents in states that do not opt into the expansion.

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Geography and the Medicaid Mental Health Care Infrastructure

Cited by 73 publications

References 21 publications

Race/Ethnicity and Geographic Access to Medicaid Substance Use Disorder Treatment Facilities in the United States

Race/Ethnicity and Geographic Access to Medicaid Substance Use Disorder Treatment Facilities in the United States

Uses of Research Evidence by State Legislators Who Prioritize Behavioral Health Issues

Decline In Public Substance Use Disorder Treatment Centers Most Serious In Counties With High Shares Of Black Residents

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