Monday, June 27, 2005

Medicaid Managed Care: Looking Forward, Looking Back National Academy for State Health Policy report (in PDF format) - " Since 1990 managed care has grown to be the dominant delivery system in Medicaid. State Medicaid agencies have both expanded managed care to cover more complex populations and established mechanisms to ensure access and quality. These years have also seen a consolidation in the Medicaid marketplace and the increased use of managed care organizations (MCOs) that serve a primarily public population (Medicaid, Medicare, and SCHIP). The National Academy for State Health Policy (NASHP) has tracked these and other changes through six surveys of state Medicaid managed care programs conducted in 1990, 1994, 1996, 1998, 2000, and 2002. All six surveys were developed with extensive input from state officials, and all 50 states and the District of Columbia responded to each survey. Each survey gathered information on the scope and operation of two major types of managed care: risk and primary care case management (PCCM). NASHP staff conducted a focus group in March 2005 to review the information collected in all six surveys to identify key findings, trends that may continue, and factors that may impact the future of Medicaid managed care..."  
  

Refugees face new hurdles as mental health money disappears Newsday story - "As the number of refugees rises worldwide, a clear picture of their mental health is just as difficult to find. And the federal government's refugee resettlement office no longer offers money to help. ... About 10 percent of adult refugees in Western countries have post-traumatic stress disorder, and about 5 percent have a major depressive illness, according to a report this spring in the British health journal The Lancet. Only a minority have access to help. And the world saw 1 million new refugees last year, according to a report last week by the U.S. Committee for Refugees and Immigrants. Of those, 52,868 were resettled in the U.S. 'The mental health of refugees and other displaced people therefore is a major global health problem, and one that is not going to fade with time,' The Lancet wrote in an editorial."  
  

Patients' Diversity Is Often Discounted Washington Post story - "When UCLA researchers reviewed the best available studies of psychiatric drugs for depression, bipolar disorder, schizophrenia and attention deficit disorder, they found that the trials had involved 9,327 patients over the years. When the team looked to see how many patients were Native Americans, the answer was: Zero. ... Native Americans are not the only group for whom psychiatrists write prescriptions with fingers crossed, the researchers at the University of California at Los Angeles found as they reviewed the data for a U.S. surgeon general's report: Of 3,980 patients in antidepressant studies, only two were Hispanic. Of 2,865 schizophrenia patients, three were Asian. ... In all, just 8 percent of the patients studied were minorities. It is but one example of a larger pattern: Scientists have broadly played down the role of cultural factors in the diagnosis, treatment and outcome of mental disorders." [Viewing Washington Post stories requires registration, which is free.]