title: Enrollment of Specialty Mental Health Clinics in a State Medicaid Program to Promote General Medical Services.
abstract: To promote integrated general medical care for individuals with serious mental illness, the New York State Office of Mental Health (OMH) established regulations allowing specialty mental health clinics to provide Medicaid-reimbursable health monitoring (HM) and health physicals (HP). This study examined clinics' enrollment in this program to understand its potential to reach individuals with serious mental illness.
  
  
  
  Information on enrollment and characteristics of clinics (N=500) was obtained from OMH administrative databases. Clinic enrollment in the HM/HP program was examined for the program's first five years (2010-2015). Logistic regression models accounting for the clustering of multiple clinics within agencies were used to examine characteristics associated with enrollment.
  
  
  
  A total of 291 of 500 (58%) licensed clinics in New York State in 2015 enrolled in the HM/HP program, potentially reaching 62% of all Medicaid enrollees with serious mental illness seen in specialty mental health clinics in the state. State-operated clinics were required to participate, and had 91% enrollment. Over half of hospital-affiliated and freestanding mental health clinics elected to enroll (53% and 54%, respectively). In adjusted models, enrollment was higher among freestanding clinics compared with hospital-affiliated clinics, higher in larger than smaller clinics, and higher in county-operated than in private nonprofit clinics.
  
  
  
  The high level of enrollment in the HM/HP program indicates strong interest among mental health clinics in providing general medical care services. However, supplemental policies may be needed to extend the program to areas of the mental health system where barriers to general medical care services are highest.
authors.affiliation: Dr. Breslau, Dr. Yu, Dr. Scharf, and Ms. Connor are with the Health and Behavioral Sciences Division, RAND Corporation, Pittsburgh (e-mail: jbreslau@rand.org ). Dr. Horvitz-Lennon is with the Health Division, RAND Corporation, Boston. Dr. Leckman-Westin is with the New York State Office of Mental Health (NYSOMH), Albany, and with the Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Rensselaer, New York. Dr. Finnerty is with the NYSOMH, New York City.
authors.forename: Joshua
authors.initials: J
authors.lastname: Breslau
authors.affiliation: Dr. Breslau, Dr. Yu, Dr. Scharf, and Ms. Connor are with the Health and Behavioral Sciences Division, RAND Corporation, Pittsburgh (e-mail: jbreslau@rand.org ). Dr. Horvitz-Lennon is with the Health Division, RAND Corporation, Boston. Dr. Leckman-Westin is with the New York State Office of Mental Health (NYSOMH), Albany, and with the Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Rensselaer, New York. Dr. Finnerty is with the NYSOMH, New York City.
authors.forename: Hao
authors.initials: H
authors.lastname: Yu
authors.affiliation: Dr. Breslau, Dr. Yu, Dr. Scharf, and Ms. Connor are with the Health and Behavioral Sciences Division, RAND Corporation, Pittsburgh (e-mail: jbreslau@rand.org ). Dr. Horvitz-Lennon is with the Health Division, RAND Corporation, Boston. Dr. Leckman-Westin is with the New York State Office of Mental Health (NYSOMH), Albany, and with the Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Rensselaer, New York. Dr. Finnerty is with the NYSOMH, New York City.
authors.forename: Marcela
authors.initials: M
authors.lastname: Horvitz-Lennon
authors.affiliation: Dr. Breslau, Dr. Yu, Dr. Scharf, and Ms. Connor are with the Health and Behavioral Sciences Division, RAND Corporation, Pittsburgh (e-mail: jbreslau@rand.org ). Dr. Horvitz-Lennon is with the Health Division, RAND Corporation, Boston. Dr. Leckman-Westin is with the New York State Office of Mental Health (NYSOMH), Albany, and with the Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Rensselaer, New York. Dr. Finnerty is with the NYSOMH, New York City.
authors.forename: Emily
authors.initials: E
authors.lastname: Leckman-Westin
authors.affiliation: Dr. Breslau, Dr. Yu, Dr. Scharf, and Ms. Connor are with the Health and Behavioral Sciences Division, RAND Corporation, Pittsburgh (e-mail: jbreslau@rand.org ). Dr. Horvitz-Lennon is with the Health Division, RAND Corporation, Boston. Dr. Leckman-Westin is with the New York State Office of Mental Health (NYSOMH), Albany, and with the Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Rensselaer, New York. Dr. Finnerty is with the NYSOMH, New York City.
authors.forename: Deborah M
authors.initials: DM
authors.lastname: Scharf
authors.affiliation: Dr. Breslau, Dr. Yu, Dr. Scharf, and Ms. Connor are with the Health and Behavioral Sciences Division, RAND Corporation, Pittsburgh (e-mail: jbreslau@rand.org ). Dr. Horvitz-Lennon is with the Health Division, RAND Corporation, Boston. Dr. Leckman-Westin is with the New York State Office of Mental Health (NYSOMH), Albany, and with the Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Rensselaer, New York. Dr. Finnerty is with the NYSOMH, New York City.
authors.forename: Kathryn L
authors.initials: KL
authors.lastname: Connor
authors.affiliation: Dr. Breslau, Dr. Yu, Dr. Scharf, and Ms. Connor are with the Health and Behavioral Sciences Division, RAND Corporation, Pittsburgh (e-mail: jbreslau@rand.org ). Dr. Horvitz-Lennon is with the Health Division, RAND Corporation, Boston. Dr. Leckman-Westin is with the New York State Office of Mental Health (NYSOMH), Albany, and with the Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Rensselaer, New York. Dr. Finnerty is with the NYSOMH, New York City.
authors.forename: Molly T
authors.initials: MT
authors.lastname: Finnerty
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data*; D002648:Child; D019033:Delivery of Health Care, Integrated / Q000706:statistics & numerical data*; D006761:Hospitals / Q000706:statistics & numerical data*; D006801:Humans; D008484:Medicaid / Q000706:statistics & numerical data*; D001523:Mental Disorders / Q000628:therapy*; D008605:Mental Health Services / Q000706:statistics & numerical data*; D009518:New York; D014481:United States