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Washington State Institute for Public Policy
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Medicaid Health Homes

Adult Mental Health
  Literature review updated December 2014.
This program was archived December 2024.

A Medicaid health home offers coordinated care to individuals with multiple chronic health conditions, including mental health and substance use disorders. The health home builds linkages to community supports and resources as well as enhances coordination and integration of primary and behavioral healthcare to better meet the needs of people with multiple chronic illnesses. The model aims to improve healthcare quality while also reducing costs. Health homes provide comprehensive case management, care coordination, health promotion, and transitional care when moving from inpatient to other settings (SAMHSA Health Home Fact Sheet, http://www.integration.samhsa.gov/integrated-care-models/Health_Homes_Fact_Sheet_FINAL.pdf).
 
ALL
META-ANALYSIS
CITATIONS

Meta-analysis is a statistical method to combine the results from separate studies on a program, policy, or topic to estimate its effect on an outcome. WSIPP systematically evaluates all credible evaluations we can locate on each topic. The outcomes measured are the program impacts measured in the research literature (for example, impacts on crime or educational attainment). Treatment N represents the total number of individuals or units in the treatment group across the included studies.

An effect size (ES) is a standard metric that summarizes the degree to which a program or policy affects a measured outcome. If the effect size is positive, the outcome increases. If the effect size is negative, the outcome decreases. See Estimating Program Effects Using Effect Sizes for additional information on how we estimate effect sizes.

The effect size may be adjusted from the unadjusted effect size estimated in the meta-analysis. Historically, WSIPP adjusted effect sizes to some programs based on the methodological characteristics of the study. For programs reviewed in 2024 or later, we do not make additional adjustments, and we use the unadjusted effect size whenever we run a benefit-cost analysis.

Research shows the magnitude of effects may change over time. For those effect sizes, we estimate outcome-based adjustments, which we apply between the first time ES is estimated and the second time ES is estimated. More details about these adjustments can be found in our Technical Documentation.

Meta-Analysis of Program Effects
Outcomes measured No. of effect sizes Treatment N Effect sizes (ES) and standard errors (SE) Unadjusted effect size (random effects model)
ES SE Age ES p-value
Global functioning
How well individuals (typically those who are developmentally disabled or seriously mentally ill) have adapted to activities of daily living.
 47 1 27 0.340 0.265 49 0.340 0.199
Hospitalization (psychiatric)
Admission to a psychiatric ward or hospital.
 47 1 205 -0.220 0.099 49 -0.220 0.027
Emergency department visits
Whether someone visited the emergency department, or the number of times they visited the emergency department.
47 1 205 -0.073 0.099 49 -0.073 0.463
Primary care visits
Visit to a primary care physician for any reason.
 47 1 205 0.472 0.127 49 0.472 0.001
Psychiatric symptoms
Mental health symptoms (such as symptoms of psychosis) in individuals with serious mental illness, measured on a validated scale.
 47 1 27 0.173 0.264 49 0.173 0.512

Citations Used in the Meta-Analysis

Druss, B.G., von, E.S.A., Compton, M.T., Rask, K.J., Zhao, L., & Parker, R.M. (2010). A randomized trial of medical care management for community mental health settings: the Primary Care Access, Referral, and Evaluation (PCARE) study. The American Journal of Psychiatry, 167(2), 151-9.

Druss, B.G., von Esenwein, S.A., Compton, M.T., Zhao, L., & Leslie, D.L. (2011). Budget impact and sustainability of medical care management for persons with serious mental illnesses. The American Journal of Psychiatry, 168(11), 1171-1178.

Kilbourne, A.M., Post, E.P., Nossek, A., Drill, L., Cooley, S., & Bauer, M.S. (2008). Improving medical and psychiatric outcomes among individuals with bipolar disorder: A randomized controlled trial. Psychiatric Services, 59(7), 760-768.