Using MSIS Data to Analyze Mental Health Service Use and Expenditures for Medicaid Beneficiaries with Mental Illness in New Jersey in 1999

摘要

Many Medicaid beneficiaries with chronic mental illness have serious difficulty finding services that will assist them to live in communities and participate in the full range of social activities. Recent national policy reports (GAO 2003$ New Freedom Commission on Mental Health 2003) and judicial decisions (U.S. Supreme Court 1999) underscore the critical need to improve the mental health service system, and policymakers, program administrators, and advocacy groups are working to develop effective community-based alternatives to placement in psychiatric hospitals or residential facilities (see, for example, Bazelon 2001). A major obstacle impeding these efforts is the lack of adequate information on what medical and mental health services these individuals use and how much Medicaid spends for their care. Without a better foundation of knowledge, state Medicaid agencies are reluctant to expand services or develop new initiatives for individuals with chronic mental illness, particularly when state governments are facing financial shortfalls. The Office of the Assistant Secretary for Planning and Evaluation (ASPE) in the Department of Health and Human Services (HHS) plays an important role in establishing national policies for Medicaid and assisting state Medicaid agencies to address emerging policy issues effectively. As part of its mission, ASPE identifies opportunities to develop new sources of information and conduct studies that will be useful to state Medicaid staff and other key stakeholders. The study described in this report was designed to determine whether the Medicaid Statistical Information System (MSIS) files could be used to generate policy-relevant information on the use and costs of Medicaid services for beneficiaries with mental illness. MSIS files provide substantial individual-level information on the services that beneficiaries use, the costs of these services, and demographic and program eligibility characteristics of beneficiaries. The study described in this report is one of the first to use MSIS files to examine services for Medicaid beneficiaries with mental illness and it demonstrates how data in these files can be used to address policy issues affecting these individuals. Specifically, in this study we aim to (1) describe Medicaid services used by beneficiaries with mental illness in one state and (2) assess the feasibility of using MSIS data for analyses of mental health services. If MSIS files are found to be useful for this purpose, OASPE or other agencies could consider further analyses of MSIS data to investigate patterns in the use and cost of mental health services.