Health Insurance Coverage Among Persons With Schizophrenia in the United States

Khaykin, M.H.S. Elizabeth; Eaton, William W.; Ford, M.P.H. Daniel E.; Anthony, Bethany; Daumit, M.H.S. Gail L.

doi:10.1176/ps.2010.61.8.830

Cited by 71 publications

(44 citation statements)

References 12 publications

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“…We are unable to determine the stage of cancer at diagnosis and the Medicaid sample does not include all persons with schizophrenia or bipolar disorder in the state; some persons with serious mental illness may have private insurance or be covered by social security disability insurance rather than SSI, and this group is likely of higher socioeconomic status than the study population. However, a 2010 study shows that 87% of persons with schizophrenia receive government health insurance like Medicaid, suggesting that our population is likely representative of much of the population of interest (12). In addition, the Medicaid sample by definition covers an insured population, while the SEER data is population-based and includes persons without insurance.…”

Section: Discussionmentioning

confidence: 98%

Cancer Incidence in a Sample of Maryland Residents With Serious Mental Illness

McGinty¹,

Zhang²,

Güallar³

et al. 2012

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Objective Persons with serious mental illness have an increased mortality rate and a higher burden of many medical conditions compared to those without serious mental illness, but cancer risk in the serious mental illness population is uncertain. Cancer incidence in a community-based cohort of adults with schizophrenia or bipolar disorder was examined by race, sex, and cancer site. Methods We calculated standardized incidence ratios of total and site-specific cancers comparing a cohort of 3317 Maryland Medicaid adult beneficiaries with schizophrenia or bipolar disorder followed from 1994 through 2004 to the U.S. population. Results Total cancer incidence for adults with schizophrenia or bipolar disorder was 2.6 times higher than in the U.S. population. Elevated risk in persons with serious mental illness was greatest for cancer of the lung and bronchus. No differences in risk were found for African American versus white Medicaid beneficiaries with serious mental illness. Conclusion These findings suggest heightened risk for cancer among adults with schizophrenia or bipolar disorder. Clinicians should promote appropriate cancer screening and work to reduce modifiable risk factors, such as smoking, among persons with serious mental illness.

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Section: Discussionmentioning

confidence: 98%

Cancer Incidence in a Sample of Maryland Residents With Serious Mental Illness

McGinty¹,

Zhang²,

Güallar³

et al. 2012

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“…Eighty-seven percent of persons with schizophrenia are insured by Medicaid or Medicare, and another 8% are insured by the Veteran’s Health Administration. 114 The Centers for Medicare and Medicaid services (CMS) and the Veteran’s Administration (VA) are federal agencies that already have access to national administrative claims datasets for their beneficiaries. While Medicaid is directly administered at the state level, state agencies are required to report administrative data to CMS, facilitating calculation of national claims-based estimates of cost and quality of care.…”

Section: Discussionmentioning

confidence: 99%

Review of the evidence: prevalence of medical conditions in the United States population with serious mental illness

Janssen

McGinty

Azrin

et al. 2015

General Hospital Psychiatry

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151

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Objective Persons with serious mental illness (SMI) have high rates of premature mortality from preventable medical conditions, but this group is underrepresented in epidemiologic surveys and we lack national estimates of the prevalence of conditions such as obesity and diabetes in this group. We performed a comprehensive review to synthesize estimates of the prevalence of 15 medical conditions among the population with SMI. Method We reviewed studies published in the peer-reviewed literature from January 2000-August 2012. Studies were included if they assessed prevalence in a sample of 100 or more US adults with schizophrenia or bipolar disorder. Results 57 studies were included in the review. For most medical conditions, the prevalence estimates varied considerably. For example, estimates of obesity prevalence ranged from 26% to 55%. This variation appeared to be due to differences in measurement (e.g. self-report versus clinical measures) and underlying differences in study populations. Few studies assessed prevalence in representative, community samples of persons with SMI. Conclusions In many studies, the prevalence of medical conditions among the population with SMI was higher than among the overall US population. Screening for and monitoring of these conditions should be common practice in clinical settings serving persons with SMI.

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“…Approximately two-thirds of Americans with schizophrenia are enrolled in Medicaid. 34 However, psychiatrists are much less likely than most other medical specialists to accept Medicaid. In 2009-10 the Medicaid acceptance rate for office-based psychiatrists was 43 percent, compared with 73 percent for all other specialists.…”

Section: Psychologists and Psychiatristsmentioning

confidence: 99%

Building The Mental Health Workforce Capacity Needed To Treat Adults With Serious Mental Illnesses

Olfson

2016

Health Affairs

133

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There are widespread shortages of mental health professionals in the United States, especially for the care of adults with serious mental illnesses. Such shortages are aggravated by maldistribution of mental health professionals and attractive practice opportunities treating adults with less severe conditions. The Affordable Care Act (ACA) and legislation extending mental health parity coverage are contributing to an increasing demand for mental health services. I consider four policy recommendations to reinvigorate the mental health workforce to meet the rising mental health care demand by adults with serious mental illnesses: expanding loan repayment programs for mental health professionals to practice in underserved areas; raising Medicaid reimbursement for treating serious mental illness; increasing training opportunities for social workers in relevant evidence-based psychosocial services; and disseminating service models that integrate mental health specialists as consultants in general medical care. Achieving progress in attracting mental health professionals to care for adults with serious mental illnesses will require vigorous policy interventions.

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Health Insurance Coverage Among Persons With Schizophrenia in the United States

Abstract: Almost all U.S. adults with schizophrenia were found to receive government health insurance, yet a measurable minority remained uninsured. These national estimates highlight opportunities for improving health service delivery for this vulnerable population.

Cited by 71 publications

References 12 publications

Cancer Incidence in a Sample of Maryland Residents With Serious Mental Illness

Cancer Incidence in a Sample of Maryland Residents With Serious Mental Illness

Review of the evidence: prevalence of medical conditions in the United States population with serious mental illness

Building The Mental Health Workforce Capacity Needed To Treat Adults With Serious Mental Illnesses

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