Washington State Department of Social and Health Services

Research & Data Analysis Division


Publication cover for 'Outpatient Mental Health Services and Medical Cost Offsets'

Apr 13 | 3.39 | Online Library

Outpatient Mental Health Services and Medical Cost Offsets

Mental health services for Medicaid enrollees in Washington are provided through a tiered delivery system. Regional Support Networks (RSNs) manage outpatient and inpatient mental health services for Medicaid enrollees who meet access to care standards defined by diagnosis and level of functioning criteria. Medicaid enrollees who have mental health needs but do not meet the access to care standard may access a limited number of mental health therapy visits through their Medicaid medical benefit. This study compares medical cost and mortality outcomes for Disabled Medicaid adults with mental health needs served in the RSN system with outcomes for clients with similar mental health conditions who are served outside of the RSN system to see whether receipt of RSN outpatient services is associated with medical cost savings. We found Disabled Medicaid adults with depression or anxiety treated in the RSN system have significantly lower medical costs over a 5-year follow-up period, compared to similar Disabled Medicaid adults not served in the RSN system. The lower costs for adults with depression or anxiety treated in the RSN system are driven by significantly lower inpatient medical costs associated with emergency department activity; 83 percent of the cost of RSN services for adults with depression or anxiety is directly offset by savings in medical costs. The average net cost of RSN outpatient services received over the five-year period was $132 per member per month, with an average medical cost offset of $109 per member per month.