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Sunday, February 13, 2005
Mental health story needs clarification
Copyright © 2005 Blethen Maine Newspapers Inc. | ||||
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My co-authors, David Lambert and Stuart Bratesman, and I found that, from 1996 to 2002, for all MaineCare members, spending on behavioral health care services increased much more rapidly -- 163 percent -- than spending on medical services, which rose 112 percent, or spending on long-term care such as nursing home or home health care, which rose 6 percent. We found that behavioral health care services grew from 27 percent of all MaineCare expenditures to 37 percent in the six years. Total MaineCare spending on members with behavioral conditions increased 119 percent, compared to 30 percent for other MaineCare members. (This 119 percent increase is for all services for MaineCare members with behavioral conditions, not for "an array of behavioral health services," as the article describes.) Spending increased at different rates for the nine different behavioral conditions we studied. The greater cost increase for behavioral compared to medical or long-term care services was a result of more members diagnosed with behavioral conditions and more spent per month on their services. Many changes contribute to this, including greater awareness of mental- health problems, expanded programs for children with behavioral conditions, access to more effective treatments and medications, and a shift by the state of coverage onto Medicaid to increase access to federal funds. These increases are dramatic and warrant careful consideration. We hope that the focus will be more on assuring that services are provided efficiently and effectively and less on limiting the number of people receiving services, and that detailed studies like this will help policy-makers, advocates and citizens make informed choices about spending while assuring access to care for people with behavioral health conditions. Susan M. C. Payne Professor and senior research associate Institute for Health Policy Muskie School of Public Service University of Southern Maine Portland |
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