#  Improving quality and value of serious mental illness care in Medicaid 

 



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## **Addressing gaps in the evidence to improve quality and value of Serious Mental Illness care in Medicaid**

[5R01MH136658-02 ](https://reporter.nih.gov/search/WsTcYowpzkmRjq58HO5jiw/project-details/11063152)

04/2024 -- 01/2026

*Medicaid* is a key player in the *care* of individuals living with *serious* *mental* *illness* (SMI). Despite its high costs, *Medicaid*-funded SMI *care* is characterized by low *quality* and inequities. Although state *Medicaid* programs have implemented policies to *improve* *quality* or *value* of *care* for high-need beneficiaries including those with SMI, policymakers lack the necessary information to develop, target, implement, and evaluate these policies. For example, the associations between person- and area-level characteristics and *quality* of SMI *care* are not well understood, precluding the targeting of corrective interventions. Moreover, concerns have been raised about SMI *quality* measurement, with some arguing that available process-based indicators do not cover key areas of SMI *care* and may not be associated with key patient outcomes, both health outcomes (e.g., suicidality) and social outcomes (e.g., homelessness). Crucially, the *quality* and cost effects of the broad adoption of telehealth to deliver *mental* health *care* following the COVID-19 pandemic are not well understood, nor are its effects on disparities. Last, because little is known about the relationships between *quality*, health and social outcomes, and *Medicaid* and other costs or their interplay with race/ethnicity, policymakers lack a full understanding of the state budgetary and societal impacts of interventions to *improve* the *quality* and equity of SMI *care*. Our proposed research seeks to fill these *evidence* *gaps* hindering policymakers’ efforts to *improve* *quality*, equity, and *value* of SMI *care*. We will leverage an ongoing partnership with the New York State *Medicaid* program’s *mental* health authority, availability of several patient-level datasets, and subject matter and methods expertise. Aim 1 will identify person- and area-level predictors of *quality* of *care* and determine if the associations vary by race/ethnicity. Aim 2 will estimate the effects of receipt of high-*quality* *care* on health and social outcomes and determine if the effects vary by race/ethnicity. Aim 3 will estimate the effects of telehealth on *quality* of *mental* health *care* and costs to *Medicaid* and determine if the effects vary by race/ethnicity. Aim 4 will develop alternative *quality*-improving interventions and compare their effects on health and social outcomes, *Medicaid* and broader state spending, and racial/ethnic equity. Our proposed research is responsive to PAR-23-095 and aligned with the NIMH Strategic Plan’s Goal 4 because, among other tasks, we will (a) identify mutable factors that are likely to influence disparities in *quality* and outcomes for underserved groups, (b) use large representative data sets and novel computational approaches to *improve* *mental* health *care* and its outcomes, and (c) evaluate the impacts of an innovation (telehealth). Successful completion of our aims will provide policymakers with race/ethnicity-infused *evidence* regarding (a) groups to be targeted for interventions to *improve* *quality* of *care*, (b) the effects of high-*quality* *care* on key patient outcomes, (c) the effects of tele*mental* health policies, and (d) the comparative effects of alternative *quality*- improving interventions on outcomes of high significance to patients, state policymakers, and society.



 



 

 See also:- [ Current Projects ](/page-categories/current-projects)