February 2016

Behavioral Health Care in HUSKY A Before and After Implementation of Connecticut's Behavioral Health Partnership: Children and Adults with Diagnosed Mental Conditions

Mary Alice Lee, Ph.D., Sarah Iverson and Sharon Langer M.Ed., J.D.

On January 1, 2006, the Connecticut Behavioral Health Partnership, an administered fee-for-service Medicaid program, was created with the goal of improving access to care by providing beneficiaries with a coordinated and effective system of community-based behavioral health services and support for individuals who need care.

Prior to 2006, behavioral health services for children and families were provided along with all other health services in a risk-based Medicaid managed care program.  We compared the prevalence of diagnosed mental disorders among children and adults in HUSKY A (Medicaid) before (2004-2005) and after (2012-2013) the program change.  We found that:

  • Enrollment in the HUSKY Program increased significantly. 
  • Utilization of behavioral health services increased significantly in terms of the number and percentages with care. 
    • Increased utilization was evident in all age, racial/ethnic, primary language, and residential groupings.
    • The distribution of diagnosed mental disorders across diagnostic groupings was relatively unchanged except for declines in the proportions of children with diagnosed anxiety disorder and adults with diagnosed mood disorders.

Two important caveats affect interpretation of these findings:  First, treatment prevalence does not equal actual prevalence of mental disorders; only those who received any care are counted for the estimate.  Second, trends in prevalence or service utilization observed over time may be related to but cannot be directly attributed to program changes.  However, these findings are consistent with anecdotal reports and quantitative data reported by the Connecticut Behavioral Health Partnership that show increased availability of timely, community-based services.  These findings are also consistent with results of a recently published study of behavioral health services in 20 other Medicaid programs over roughly the same time period: enrollment increased and mental disorder diagnoses increased.  Those researchers documented a similar rise in asthma diagnoses and pointed to the “importance of poverty as a factor contributing to the increasing rates of mental disorders [and asthma] in children.”

Issue Area:
Health