ArticleJAMA psychiatry2013
Geography and the Medicaid mental health care infrastructure: implications for health care reform.
Article in JAMA psychiatry, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 1 synthesis or guideline pooled it, 88 citations in OpenAlex.
- Access to specialty healthcare in urban versus rural US populations: a systematic literature review.BMC health services research · 2019Pooled it
- Patterns of treatment for psychiatric disorders among children and adolescents in Mississippi Medicaid.PloS one · 2019Trial
- Comparing Physicians' Perceptions of Access to Behavioral Health Resources in Rural and Urban Practices.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Virginia's inpatient mental healthcare geography post SB260.Health policy OPEN · 2026Article
- Implementing Coordinated Specialty Care Programs for Psychosis Across the U.S.: State-Level Administrator and Provider Perspectives.Community mental health journal · 2026Article
- 'Ghost' Physicians: More Than One-Quarter Of Physicians Enrolled In Medicaid Delivered No Care To Beneficiaries In 2021.Health affairs (Project Hope) · 2026Article
- Using large biobanks for psychiatric genomic research: Consistency of clinical and genetic aspects of recorded depression across US states in the All of Us Research Program.Psychological medicine · 2026Article
- Patterns and predictors of anxiety medication use among United States adults: a national analysis with a focus on racial disparities in the Asian population.Frontiers in public health · 2026Article
- Mental health service utilization in publicly insured survivors of childhood cancer: a claims-based analysis.JNCI cancer spectrum · 2025Article
- Variation in Hospital Admission Rates for Schizophrenia Spectrum Disorder Emergency Department Visits in 11 States.Psychiatric services (Washington, D.C.) · 2025Article
- Estimating racial and ethnic healthcare quality disparities using exploratory item response theory and latent class item response theory models.Journal of the Royal Statistical Society. Series A, (Statistics in Society) · 2025Article
- The Importance of Patient Experience in Obtaining Mental Health Care at HRSA-Funded Health Centers.Administration and policy in mental health · 2025Article
- Rural Suicide: Demographics, Causes, and Treatment Implications.Community mental health journal · 2025Article
- Implementing Reform: Approaches to Alter the Use of Local Jail for People with Behavioral Health Conditions.International journal of offender therapy and comparative criminology · 2024Article
- Racial-Ethnic Disparities in Quality of Care Among Medicaid Beneficiaries With Schizophrenia.Psychiatric services (Washington, D.C.) · 2024Article
- National and State-Level Trends in Mental Health and Substance Use Disorder Services at Federally Qualified Health Centers, 2012-2019.Journal of community health · 2024Article
- Impacts of the Affordable Care Act Medicaid Expansion on Mental Health Treatment Among Low-income Adults Across Racial/Ethnic Subgroups, 2010-2017.The journal of behavioral health services & research · 2024Article
- Rural and frontier access to mental health prescribers and nonprescribers: A geospatial analysis in Oregon Medicaid.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2024Article
- Receipt and duration of buprenorphine treatment during pregnancy and postpartum periods in a national privately-insured cohort.Drug and alcohol dependence reports · 2023Article
- Participation in Project ECHO to advance rural primary care providers' ability to address patient mental health needs.Medical education online · 2023Article
Corrections and comments
- Commented on by
Authors and funding
4 authors at 1 institution in 1 country.
Funding
Abstract
importanceMedicaid is the largest payer of mental health (MH) care in the United States, and this role will increase among states that opt into the Medicaid expansion. However, owing to the dearth of MH care providers who accept Medicaid, expanded coverage may not increase access to services. Facilities that provide specialty outpatient MH services and accept Medicaid compose the backbone of the community-based treatment infrastructure for Medicaid enrollees. For states that opt into the expansion, it is important to understand which local communities may face the greatest barriers to access these facilities.
objectiveTo examine the availability of outpatient MH facilities that accept Medicaid across US counties and whether specific types of communities are more likely to lack this infrastructure. DESIGN, SETTING, AND
participantsData from the 2008 National Survey of Mental Health Treatment Facilities and Area Resource File were merged. A generalized ordered logistic regression with state fixed effects was estimated to examine determinants of accessibility of these facilities. Covariates included the percentages of residents who are black, Hispanic, living in poverty, and living in a rural area. MAIN OUTCOMES AND MEASURES: An ordered variable assessed whether a county had no access to outpatient MH facilities that accept Medicaid, intermediate access to these facilities (ie, ≥1 facility, but not top quintile of facility to Medicaid enrollee per capita ratio), or high access (ie, top quintile of facility to Medicaid enrollee per capita ratio).
resultsMore than one-third of counties do not have any outpatient MH facilities that accept Medicaid. Communities with a larger percentage of residents who are black (marginal effect [ME] = 3.9%; 95% CI, 1.2%-6.6%), Hispanic (ME = 4.8%; 95% CI, 2.3%-7.4%), or living in a rural area (ME = 27.9%; 95% CI, 25.3%-30.4%) are more likely to lack these facilities. CONCLUSIONS AND RELEVANCE: Many communities may face constraints on the MH safety-net system as Medicaid is expanded, especially rural communities and communities with a large percentage of black or Hispanic residents.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.