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Development of a Medicaid Behavioral Health Case-Mix Model

Department of Mental Health Law and Policy, Florida Mental Health Institute, Tampa, Florida, jrobst{at}fmhi.usf.edu, Department of Economics, University of South Florida, Tampa, Florida, Institute for the Study of Labor (IZA), Bonn, Germany

Many Medicaid programs have either fully or partially carved out mental health services. The evaluation of carve-out plans requires a case-mix model that accounts for differing health status across Medicaid managed care plans. This article develops a diagnosis-based case-mix adjustment system specific to Medicaid behavioral health care. Several different model specifications are compared that use untransformed, square root transformed, and log-transformed expenditures.

Key Words: risk adjustment • case mix • Medicaid • carve-out

This version was published on December 1, 2009

Evaluation Review, Vol. 33, No. 6, 519-538 (2009)
DOI: 10.1177/0193841X09349420


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