Integrated care models and behavioral health care utilization: Quasi‐experimental evidence from Medicaid health homes
利用2010-2016年美国全国药物使用与健康调查数据，采用双向固定效应模型，首次在人群层面评估医疗补助健康之家对行为健康服务利用的影响，发现该模式增加了服务使用并改善了自评健康。
Integration of behavioral and general medical care can improve outcomes for individuals with behavioral health conditions-serious mental illness (SMI) and substance use disorder (SUD). However, behavioral health care has historically been segregated from general medical care in many countries. We provide the first population-level evidence on the effects of Medicaid health homes (HH) on behavioral health care service use. Medicaid, a public insurance program in the United States, HHs were created under the 2010 Affordable Care Act to coordinate behavioral and general medical care for enrollees with behavioral health conditions. As of 2016, 16 states had adopted an HH for enrollees with SMI and/or SUD. We use data from the National Survey on Drug Use and Health over the period 2010 to 2016 coupled with a two-way fixed-effects model to estimate HH effects on behavioral health care utilization. We find that HH adoption increases service use among enrollees, although mental health care treatment findings are sensitive to specification. Further, enrollee self-reported health improves post-HH.