Prevalence and Impact of Behavioral Health Conditions in Medicaid
Identifying beneficiaries with behavioral and physical health comorbidities is a critical step toward integrating and improving care. The following resources can help states identify high-opportunity subsets of beneficiaries for enhanced care management.
- Clarifying Multimorbidity Patterns to Improve Targeting and Delivery of Clinical Services for Medicaid Populations This Faces of Medicaid analysis from CHCS examines multimorbidity patterns among adult Medicaid beneficiaries with disabilities and explores the implications of specific patterns on hospitalization and cost. The findings point to the pervasiveness of mental illness among Medicaid’s highest-cost subsets and the need to integrate physical and behavioral health services.
- Faces of Medicaid III: Refining the Portrait of People with Multiple Chronic Conditions This CHCS Faces of Medicaid analysis provides a close-up look at Medicaid beneficiaries with comorbidities, and highlights the frequency of mental illness among this population.
- Hospital Readmissions among Medicaid Beneficiaries with Disabilities: Identifying Targets of Opportunity This nationwide analysis of Medicaid hospital readmissions highlights the impact of behavioral health conditions on readmissions risk and targets opportunities for addressing repeat visits.
- Faces of Medicaid Data Resources CHCS’ ongoing series of national analyses provides insights into the prevalence of specific conditions among Medicaid beneficiaries and their patterns of service use.
Screening and Assessment Tools
Following are examples of screening and assessment tools.
- Patient Health Questionnaire-2 (PHQ-2) This two-item self-report tool inquires about the frequency of depressed mood and anhedonia. The PHQ-2 includes the first two items of the Patient Health Questionnaire (PHQ-9) that screens for and diagnoses depression based on DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) criteria. Subject to copyright.
- Patient Health Questionnaire-9 (PHQ-9) This nine-item depression scale can assist primary care clinicians in diagnosing depression as well as selecting and monitoring treatment. The PHQ-9 is based directly on the diagnostic criteria for major depressive disorder in the Diagnostic and Statistical Manual Fourth Edition (DSM-IV). Subject to copyright.
- Generalized Anxiety Disorder 7-item (GAD-7) Scale This clinical measurement tool can serve as a screening instrument to identify probable cases of generalized anxiety disorder (GAD), as well as severity of the disorder. Subject to copyright.
- Global Assessment of Functioning (GAF) Scale This numeric scale can be used by mental health clinicians and physicians to subjectively rate the social, occupational, and psychological functioning of adults. Available for use in the public domain.
- Overall Anxiety Severity and Impairment Scale (OASIS) This five-item self-report measure can be used to assess severity and impairment associated with any anxiety disorder or multiple anxiety disorders. Available for use in the public domain.