The effects of the Maryland Medicaid Health Home Waiver on Emergency Department and inpatient utilization among individuals with serious mental illness.

Objective: The Maryland Medicaid health home program, established through the Affordable Care Act's Medicaid health home waiver, integrates primary care services into specialty mental health programs for adults with serious mental illness (SMI). We evaluated the effect of this program on all-cause, physical, and behavioral health emergency department (ED) and inpatient utilization.

Method: Using marginal structural modeling to control for time-invariant and time-varying confounding, we analyzed Medicaid administrative claims data for 12,232 enrollees with SMI from October 1, 2012 to December 31, 2016; 3319 individuals were enrolled in a BHH and 8913 were never enrolled.

Predictors of outpatient mental health clinic follow-up after hospitalization among Medicaid-enrolled young adults.

Aim: To assess demographic and clinical predictors of outpatient mental health clinic follow-up after inpatient psychiatric hospitalization among Medicaid-enrolled young adults.

Methods: Using logistic regression and administrative claims data from the Maryland public mental health system and Maryland Medicaid for young adults ages 18-26 who were enrolled in Medicaid (N = 1127), the likelihood of outpatient mental health follow-up within 30 days after inpatient psychiatric hospitalization was estimated .

Results: Only 51% of the young adults had any outpatient mental health follow-up visits within 30 days of discharge.

Transcranial Doppler screening of Medicaid-insured children with sickle cell disease.

Transcranial Doppler screening reduces the risk of stroke in children with sickle cell disease. We tested the effect of informational letters sent to parents and doctors of Medicaid-insured children on improving screening efficiency. The letters did not improve the low baseline screening rates, suggesting the need for more aggressive outreach.

Identifying young adults at risk of Medicaid enrollment lapses after inpatient mental health treatment.

Objective: This study sought to describe Medicaid disenrollment rates and risk factors among young adults after discharge from inpatient psychiatric treatment.

Methods: The sample included 1,176 Medicaid-enrolled young adults ages 18 to 26 discharged from inpatient psychiatric care in a mid-Atlantic state. Medicaid disenrollment in the 365 days postdischarge and disenrollment predictors from the 180-day predischarge period (antecedent period) were identified from administrative records.

Medicaid lapses and low-income young adults' receipt of outpatient mental health care after an inpatient stay.

Objective: This study examined low-income young adults' use of outpatient mental health services after an inpatient mental health stay, with a focus on Medicaid enrollment lapses and public mental health safety-net coverage.

Methods: The sample included 1,174 young adults ages 18 to 26 who had been discharged from inpatient psychiatric care in a mid-Atlantic state. All were enrolled in Medicaid at the time of discharge, and all were eligible for continued outpatient public mental health services regardless of Medicaid enrollment.

Cervical cancer screening and acute care visits among Medicaid enrollees with mental and substance use disorders.

Objective: This study compared rates of cervical cancer screening and acute care (primary or gynecological) visits among women with and without a diagnosis of psychosis, substance use disorder, bipolar disorder or mania, or depression.

Methods: Using data about women (N=105,681) enrolled in Maryland's Medicaid program in fiscal year 2005, the authors constructed logistic models with cancer screening and acute care visits as dependent variables and serious mental illness flags as independent variables. Covariates were age, race, geography, Medicaid eligibility category, and sexually transmitted diseases.

fMRI evidence that the neural basis of response inhibition is task-dependent.

Event-related fMRI was used to investigate the hypothesis that neural activity involved in response inhibition depends upon the nature of the response being inhibited. Two different Go/No-go tasks were compared-one with a high working memory load and one with low. The 'simple' Go/No-go task with low working memory load required subjects to push a button in response to green spaceships but not red spaceships.