TY - JOUR
KW - community health center
KW - Medicaid
KW - Mental Health
KW - Patient-Centered Care
KW - Vulnerable Populations
AU - R. G. Whitaker
AU - M. Kilany
AU - R. Wells
AU - M. E. Domino
A1 - 
AB - Patient-centered medical homes based at federally-qualified health centers (FQHCs) can benefit patients with complex health needs, such as severe mental illness (SMI). However, little is known about FQHC characteristics associated with changes in health care expenditures and utilization for individuals with SMI. Using North Carolina Medicaid claims and FQHC data from the Uniform Data System, multivariate regression identified FQHC characteristics associated with total expenditures, medication adherence and emergency department utilization among adults with SMI, controlling for time-invariant differences by health center. Few of the FQHC-level factors affected the outcomes-not even offering on-site behavioral health services. Although the FQHCs in the analysis sample exhibited considerable variation in the provision of specialty behavioral services and in staffing configurations, it may be the case that the examination of average effects across a heterogeneous group of adults with SMI mask benefits of FQHCs to certain subgroups. These findings support the conclusion that there is no "one-size-fits-all" model that works best for this diverse patient population. Study results are relevant for practices embarking on expanded medical home services for people with SMI.
AD - Duke-Margolis Center for Health Policy, Duke University, 100 Fuqua Drive, Box 90120, Durham, NC, 27708-0120, USA. Rebecca.whitaker@duke.edu.; University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Rebecca.whitaker@duke.edu.; Health Care Policy Researcher, American Institutes for Research, 100 Europa Drive, Suite 315, Chapel Hill, NC, 27517, USA.; Department of Management, Policy and Community Health, The University of Texas School of Public Health, 1200 Pressler Street, Houston, TX, 77030, USA.; Department of Health Policy & Management and Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, 1105B McGavran-Greenberg Hall, CB #7411, Chapel Hill, NC, 27599-7411, USA.
BT - The Psychiatric quarterly
C5 - Education & Workforce; Financing & Sustainability; Healthcare Disparities; Medical Home
CY - United States
DO - 10.1007/s11126-020-09754-1
JF - The Psychiatric quarterly
LA - eng
M1 - Journal Article
N2 - Patient-centered medical homes based at federally-qualified health centers (FQHCs) can benefit patients with complex health needs, such as severe mental illness (SMI). However, little is known about FQHC characteristics associated with changes in health care expenditures and utilization for individuals with SMI. Using North Carolina Medicaid claims and FQHC data from the Uniform Data System, multivariate regression identified FQHC characteristics associated with total expenditures, medication adherence and emergency department utilization among adults with SMI, controlling for time-invariant differences by health center. Few of the FQHC-level factors affected the outcomes-not even offering on-site behavioral health services. Although the FQHCs in the analysis sample exhibited considerable variation in the provision of specialty behavioral services and in staffing configurations, it may be the case that the examination of average effects across a heterogeneous group of adults with SMI mask benefits of FQHCs to certain subgroups. These findings support the conclusion that there is no "one-size-fits-all" model that works best for this diverse patient population. Study results are relevant for practices embarking on expanded medical home services for people with SMI.
PP - United States
PY - 2020
SN - 1573-6709; 0033-2720
T1 - Are Certain Health Centers Better Patient-Centered Medical Homes for People with Severe Mental Illness?
T2 - The Psychiatric quarterly
TI - Are Certain Health Centers Better Patient-Centered Medical Homes for People with Severe Mental Illness?
U1 - Education & Workforce; Financing & Sustainability; Healthcare Disparities; Medical Home
U2 - 32468400
U3 - 10.1007/s11126-020-09754-1
VO - 1573-6709; 0033-2720
Y1 - 2020
Y2 - May 28
ER -