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Healthcare 2017, 5(3), 32; doi:10.3390/healthcare5030032

Integrating Mental and Physical Health Care for Low-Income Americans: Assessing a Federal Program’s Initial Impact on Access and Cost

Division of Health Services Management & Policy, College of Public Health, The Ohio State University, Columbus, OH 43210, USA
Academic Editor: Sampath Parthasarathy
Received: 6 June 2017 / Revised: 7 July 2017 / Accepted: 10 July 2017 / Published: 12 July 2017
(This article belongs to the Special Issue Population Health Management)
View Full-Text   |   Download PDF [209 KB, uploaded 12 July 2017]

Abstract

Individuals with mental health disorders often die decades earlier than the average person, and low-income individuals disproportionately experience limited access to necessary services. In 2014, the U.S. Health Resources & Services Administration (HRSA) leveraged Affordable Care Act funds to address these challenges through behavioral health integration. The objective of this study is to assess the US$55 million program’s first-year impact on access and cost. This analysis uses multivariable difference-in-difference regression models to estimate changes in outcomes between the original 219 Federally Qualified Health Center (FQHC) Behavioral Health Integration grantees and two comparison groups. The primary outcome variables are annual depression screening rate, percentage of mental health and substance use patients served, and per capita cost. The results change when comparing the Behavioral Health Integration (BHI) grantees to a propensity score-matched comparison group versus comparing the grantees to the full population of health centers. After one year of implementation, the grant program appeared ineffective as measured by this study’s outcomes, though costs did not significantly rise because of the program. This study has limitations that must be discussed, including non-randomized study design, FQHC data measurement, and BHI program design consequences. Time will tell if FQHC-based behavioral–physical health care integration will improve access among low-income, medically-underserved populations. View Full-Text
Keywords: mental health; behavioral health integration; Federally Qualified Health Center; community health; safety net mental health; behavioral health integration; Federally Qualified Health Center; community health; safety net
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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MDPI and ACS Style

Goldstein, E.V. Integrating Mental and Physical Health Care for Low-Income Americans: Assessing a Federal Program’s Initial Impact on Access and Cost. Healthcare 2017, 5, 32.

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