title: Medicaid Spending Differences for Child/Youth Community-Based Care in California's Decentralized Public Mental Health System.
abstract: This study evaluated spending differences across counties during the decade after California decentralized its public mental health system. Medicaid data for 0-25 year olds using mental health services were collapsed to the county-year level (n = 627). Multivariate models with county fixed effects were used to predict per capita spending for community-based mental health care. While counties increased their spending over time, those with relatively low initial expenditures per user continued to spend less than counties with historically higher spending levels. Spending differences per user were most noticeable in counties with larger racial/ethnic minority populations that also had historically lower spending levels.
authors.affiliation: Center for Innovation to Implementation, VA Palo Alto Health Care System, 795 Willow Road (152-MPD), Menlo Park, CA, 94025, USA. Megan.Vanneman@va.gov.|Center for Primary Care and Outcomes Research, Stanford University School of Medicine, 117 Encina Commons #211, Stanford, CA, 94305, USA. Megan.Vanneman@va.gov.|Department of Internal Medicine and Department of Population Health Sciences, University of Utah, Salt Lake City, UT, 84132, USA. Megan.Vanneman@va.gov.
authors.forename: Megan E
authors.initials: ME
authors.lastname: Vanneman
authors.affiliation: School of Public Health, University of California at Berkeley, Berkeley, CA, USA.
authors.forename: Lonnie R
authors.initials: LR
authors.lastname: Snowden
authors.affiliation: School of Public Health, University of California at Berkeley, Berkeley, CA, USA.
authors.forename: William H
authors.initials: WH
authors.lastname: Dow
mesh_terms: D000293:Adolescent; D000328:Adult; D002140:California; D002648:Child; D002675:Child, Preschool; D003156:Community Mental Health Services / Q000191:economics*; D005006:Ethnicity; D005260:Female; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008484:Medicaid / Q000191:economics*; D008913:Minority Groups; D015999:Multivariate Analysis; D014481:United States; D055815:Young Adult
keywords: Children; Counties; Medicaid expenditures; Public mental health system; Youth