Peer Support Services in Behavioral Health Facilities: Secondary Analysis From Two National Surveys.

Objective: Peer support providers are part of the behavioral health workforce. Research indicates that peer support helps care recipients achieve recovery and engage with behavioral health services. This article investigated how many U.

Mental Health Needs Due to Disasters: Implications for Behavioral Health Workforce Planning During the COVID-19 Pandemic.

Public health emergencies impact the well-being of people and communities. Long-term emotional distress is a pervasive and serious consequence of high levels of crisis exposure and low levels of access to mental health care. At highest risk for mental health trauma are historically medically underserved and socially marginalized populations and frontline health care workers (HCWs).

Double-edged sword of federalism: variation in essential health benefits for mental health and substance use disorder coverage in states.

The Affordable Care Act requires all insurance plans sold on health insurance marketplaces and individual and small-group plans to cover 10 Essential Health Benefits (EHB), including behavioral health services. Instead of applying a uniform EHB plan design, the Department of Health and Human Services let states define their own EHB plan. This approach was seen as the best balance between flexibility and comprehensiveness, and assumed there would be little state-to-state variation.

Overcoming Barriers to Integrating Behavioral Health and Primary Care Services.

Objective: Despite barriers, organizations with varying characteristics have achieved full integration of primary care services with providers and services that identify, treat, and manage those with mental health and substance use disorders. What are the key factors and common themes in stories of this success?

Methods: A systematic literature review and snowball sampling technique was used to identify organizations. Site visits and key informant interviews were conducted with 6 organizations that had over time integrated behavioral health and primary care services.

Effects of Mental Health Parity on High Utilizers of Services: Pre-Post Evidence From a Large, Self-Insured Employer.

Objective: This study evaluated utilization of mental health and substance use services among enrollees at a large employee health plan following changes to benefit limits after passage in 2008 of federal mental health parity legislation.

Methods: This study used a pre-post design. Benefits and claims data for 43,855 enrollees in the health plan in 2009 and 2010 were analyzed for utilization and costs after removal of a 30-visit cap on the number of covered mental health visits.

Under Pressure: Financial Effect of the Hospital-Acquired Conditions Initiative-A Statewide Analysis of Pressure Ulcer Development and Payment.

Objectives: To assess the financial effect of the 2008 Hospital-Acquired Conditions Initiative (HACI) pressure ulcer payment changes on Medicare, other payers, and hospitals.

Design: Retrospective before-and-after study of all-payer statewide administrative data for more than 2.4 million annual adult discharges in 2007 and 2009 using the Healthcare Cost and Utilization Project State Inpatient Datasets for California.

What Influences Participation in QI? A Randomized Trial of Addiction Treatment Organizations.

Healthcare providers have increased the use of quality improvement (QI) techniques, but organizational variables that affect QI uptake and implementation warrant further exploration. This study investigates organizational characteristics associated with clinics that enroll and participate over time in QI. The Network for the Improvement of Addiction Treatment (NIATx) conducted a large cluster-randomized trial of outpatient addiction treatment clinics, called NIATx 200, which randomized clinics to one of four QI implementation strategies: (1) interest circle calls, (2) coaching, (3) learning sessions, and (4) the combination of all three components.

Estimating return on investment in translational research: methods and protocols.

Assessing the value of clinical and translational research funding on accelerating the translation of scientific knowledge is a fundamental issue faced by the National Institutes of Health (NIH) and its Clinical and Translational Awards (CTSAs). To address this issue, the authors propose a model for measuring the return on investment (ROI) of one key CTSA program, the clinical research unit (CRU). By estimating the economic and social inputs and outputs of this program, this model produces multiple levels of ROI: investigator, program, and institutional estimates.

Integration of depression and primary care: barriers to adoption.

Objective: Despite the prevailing consensus as to its value, the adoption of integrated care models is not widespread. Thus, the objective of this article it to examine the barriers to the adoption of depression and primary care models in the United States.

Methods: A literature search focused on peer-reviewed journal literature in Medline and PsycInfo.

An examination of costs, charges, and payments for inpatient psychiatric treatment in community hospitals.

Objective: Hospitalization is a critical component of treatment for individuals with serious and persistent mental illness. Despite its resource intensity, the costs of inpatient psychiatric hospitalizations in the United States are not well understood. The objective of this research was to provide cost estimates for inpatient psychiatric care.

Massachusetts's experience suggests coverage alone is insufficient to increase addiction disorders treatment.

The Affordable Care Act is aimed at extending health insurance to more than thirty million Americans, including many with untreated substance use disorders. Will those who need addiction treatment receive it once they have insurance? To answer that question, we examined the experience of Massachusetts, which implemented its own universal insurance law in 2007. As did the Affordable Care Act, the Massachusetts reform incorporated substance abuse services into the essential benefits to be provided all residents.

Insurers' competitive strategy and enrollment in newly offered preferred provider organizations (PPOs).

While early growth in preferred provider organizations (PPOs) coincided with growth of managed care generally, recent expansion has come primarily at the expense of other managed care plans. Little is known about the micro behavior underlying these trends. In 2005, University of Michigan employees were offered PPOs for the first time by vendors who also offered other plans.

The 14-year course of alcoholism in a community sample: do men and women differ?

Objective: To investigate the course of alcoholism in males and females in a 14-year follow-up of persons with DSM-III alcoholism compared to very heavy drinkers and unaffected controls in a community sample.

Methods: Case-control study based on data from the 1997 Health Services Use and Cost study, a 14-year follow-up survey of 442 individuals who participated in two waves of the 1981-1983 St. Louis Epidemiologic Catchment Area study.

Effect of a medication copayment increase in veterans with schizophrenia.

Objective: To assess the effect of the 2002 Veterans Millennium Health Care Act, which raised pharmacy copayments from $2 to $7 for lower-priority patients, on medication refill decisions and health services utilization among vulnerable veterans with schizophrenia.

Study Design: Quasi-experimental.

Methods: This study used secondary data contained in the National Psychosis Registry from June 1, 2000, through September 30, 2003, for all veterans diagnosed with schizophrenia and receiving healthcare through the Department of Veterans Affairs (VA).

Serious mental illness, aging, and utilization patterns among veterans.

As veterans age, chronic physical and psychiatric conditions increasingly challenge the Veterans Health Administration. We examine influences of age and diagnosis on health care utilization, within the context of the 1995 deinstitutionalization policy of the Veterans Health Administration. Veterans were hospitalized repeatedly over 5 years with diagnoses of schizophrenia, bipolar disorder, depression, or alcohol dependence (N = 7,719).

Health care entrepreneurship: financing innovation.

Entrepreneurship is often described as the ability to create new ventures from new or existing concepts, ideas and visions. There has been significant entrepreneurial response to the changes in the scientific and social underpinnings of health care services delivery. However, a growing portion of the economic development driving health care industry expansion is threatened further by longstanding use of financing models that are suboptimal for health care ventures.

The economics of integrated depression care: the University of Michigan study.

A goal of the Robert Wood Johnson Depression and Primary Care Initiative at the University of Michigan is to create and implement the clinical care and financial systems necessary to enable links between primary care and mental health specialty depression care. This paper describes the economic issues related to resources required, the mechanisms to distribute those resources, and the support that must be garnered from stakeholders. By systematic measurement and application, we assess the cost, price and selected consequences of these efforts.

Rationing psychosocial treatments in the United States.

This paper briefly reviews the recent history of psychosocial treatment for adults with severe mental illnesses in the United States. It examines the current sources and financing of such care, revealing the planned and unplanned reclassification of entitled beneficiaries and eligible patients, appropriate treatment, acceptable outcomes, and levels and sources of payment. One illustration of this phenomenon is seen in current efforts to identify and deliver only those public services that are covered by Medicaid, so as to allocate state resources only when they can be matched by federal monies.