Costs of the Seriously Mentally Ill and Severely Emotionally Disturbed for Florida Medicaid Managed Care: 2017 and 2018

Abstract

Objectives: Mental health disorders affect 46.6 million individuals, 19% of all U.S. adults. With 2020 costs estimated at $238.4 billion, mental health disorders have become the costliest health related conditions in the nation.  Medicaid plays a substantial role in covering and paying for mental health services especially among low-income populations.  In the U.S., Medicaid is the single largest payer for mental health services accounting for approximately 26% of all behavioral health spending.  Moreover, while only one in five individuals enrolled in Medicaid has a behavioral health diagnosis, they account for almost half of all Medicaid expenditures and, in most states, are a rapidly growing problem.  However, there is limited research on important aspects of mental health expenditures.  No studies have comprehensively detailed state mental health charges and costs for institutional, office, and pharmacy services or expenditures related to the costliest Medicaid mental health patients; those that are diagnosed as seriously mentally ill (SMI) or with serious emotional disturbances (SED).  Our study seeks to fill this gap and detail the mental health expenditures for the Florida Medicaid managed medical assistance (MMA) programs with a focus on SMI and SED patients.