title: Factors affecting costs in Medicaid populations with behavioral health disorders.
abstract: BACKGROUND
  Persons with behavioral disorders incur higher healthcare costs. Although they utilize behavioral health (BH) services others do not, they also have higher utilization of medical services
  
  
  OBJECTIVE
  : To determine the degree to which higher costs for persons with BH disorders are attributable to utilization of BH services, multiple chronic medical conditions (CMCs) or other issues specific to populations with BH disorders.
  
  
  METHODS
  Data base consisted of claims for 63,141 Medicaid beneficiaries, 49% of whom had one of 5 categories of BH disorder. Generalized linear models were used to identify relative impact of demographics, BH status, multiple CMCs and primary care access on total, behavioral, nonbehavioral, and medical/surgical costs.
  
  
  RESULTS
  Number of CMCs was associated with significant increases in all cost categories, including behavioral costs. Presence of any BH disorder significantly influenced these same costs, including those not associated with BH care. Effect size in each cost category varied by BH group.
  
  
  CONCLUSIONS
  BH status has a large impact on all healthcare costs, including costs of medical and other non-BH services. The number of CMCs affects BH costs independent of BH disorder. Results suggest that costs might be reduced through better integration of behavioral and medical health services.
authors.affiliation: *Muskie School of Public Service, University of Southern Maine, Portland, ME †Integrated Care Projects, Maine DHHS, Office of Continuous Quality Improvement, Augusta ‡Health Data Resources, Muskie School of Public Service, University of Southern Maine, Portland, ME §Emeritus of Health Policy and Management, University of Michigan, Ann Arbor, MI.
authors.forename: Elsie
authors.initials: E
authors.lastname: Freeman
authors.forename: Catherine A
authors.initials: CA
authors.lastname: McGuire
authors.forename: John W
authors.initials: JW
authors.lastname: Thomas
authors.forename: Deborah A
authors.initials: DA
authors.lastname: Thayer
mesh_terms: D000328:Adult; D003365:Costs and Cost Analysis; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data*; D006801:Humans; D016014:Linear Models; D008281:Maine / Q000453:epidemiology; D008297:Male; D008484:Medicaid / Q000191:economics*; D001523:Mental Disorders / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D008603:Mental Health / Q000706:statistics & numerical data; D008605:Mental Health Services / Q000191:economics* / Q000458:organization & administration; D008875:Middle Aged; D014481:United States / Q000453:epidemiology; D055815:Young Adult