ArticleHealth services research2021
Use of behavioral health care in Medicaid managed care carve-out versus carve-in arrangements.
Article in Health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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
12 citing papers in PubMed, 14 citations in OpenAlex.
- Dental Coverage Through Medicaid Managed Care vs Fee-for-Service.JAMA health forum · 2026Article
- Ongoing Challenges to Integrating Care in Settings That Serve Patients With Serious Mental Illness and Substance Use Disorder.Psychiatric research and clinical practice · 2026Article
- Predictors of Medicaid managed care plan performance on opioid use disorder treatment quality metrics.Drug and alcohol dependence · 2025Article
- Substance use disorder treatment carve outs in Medicaid managed care.Journal of substance use and addiction treatment · 2024Article
- Access, Utilization, and Quality of Behavioral Health Integration in Medicaid Managed Care.JAMA health forum · 2023Article
- The effects of behavioral health integration in Medicaid managed care on access to mental health and primary care services-Evidence from early adopters.Health services research · 2023Article
- Characteristics of Specialty Mental Health Provider Networks in Oregon Medicaid.Psychiatric services (Washington, D.C.) · 2023Article
- Innovations in Care Delivery for Patients With Serious Mental Illness Among Accountable Care Organizations.Psychiatric services (Washington, D.C.) · 2022Article
- Phantom Networks: Discrepancies Between Reported And Realized Mental Health Care Access In Oregon Medicaid.Health affairs (Project Hope) · 2022Article
- Trends In Outpatient Mental Health Services Use Before And During The COVID-19 Pandemic.Health affairs (Project Hope) · 2022Observational
- Behavioral health carve-outs: Do they impede access or prioritize the neediest?Health services research · 2021Article
- Use of behavioral health care in Medicaid managed care carve-out versus carve-in arrangements.Health services research · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo evaluate differences in access to behavioral health services for Medicaid enrollees covered by a Medicaid entity that integrated the financing of behavioral and physical health care ("carve-in group") versus a Medicaid entity that separated this financing ("carve-out group"). DATA SOURCES/STUDY
settingMedicaid claims data from two Medicaid entities in the Portland, Oregon tri-county area in 2016. STUDY
designIn this cross-sectional study, we compared differences across enrollees in the carve-in versus carve-out group, using a machine learning approach to incorporate a large set of covariates and minimize potential selection bias. Our primary outcomes included behavioral health visits for a variety of different provider types. Secondary outcomes included inpatient, emergency department, and primary care visits. DATA COLLECTION: We used Medicaid claims, including adults with at least 9 months of enrollment. PRINCIPAL
findingsThe study population included 45,786 adults with mental health conditions. Relative to the carve-out group, individuals in the carve-in group were more likely to access outpatient behavioral health (2.39 percentage points, p < 0.0001, with a baseline rate of approximately 73%). The carve-in group was also more likely to access primary care physicians, psychologists, and social workers and less likely to access psychiatrists and behavioral health specialists. Access to outpatient behavioral health visits was more likely in the carve-in arrangement among individuals with mild or moderate mental health conditions (compared to individuals with severe mental illness) and among black enrollees (compared to white enrollees).
conclusionsFinancial integration of physical and behavioral health in Medicaid managed care was associated with greater access to behavioral health services, particularly for individuals with mild or moderate mental health conditions and for black enrollees. Recent changes to incentivize financial integration should be monitored to assess differential impacts by illness severity, race and ethnicity, provider types, and other factors.
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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.