자료유형  

 학위논문

Control Number  

0017163632

International Standard Book Number  

9798383628553

Dewey Decimal Classification Number  

361

Main Entry-Personal Name  

Baslock, Daniel Merton.

Publication, Distribution, etc. (Imprint  

[S.l.] : New York University., 2024

Publication, Distribution, etc. (Imprint  

Ann Arbor : ProQuest Dissertations & Theses, 2024

Physical Description  

185 p.

General Note  

Source: Dissertations Abstracts International, Volume: 86-02, Section: B.

General Note  

Advisor: Stanhope, Victoria.

Dissertation Note  

Thesis (Ph.D.)--New York University, 2024.

Summary, Etc.  

요약Integrated treatment has been established as efficient and effective treatment for a variety of co-occurring mental health and substance use disorders. The limited integration of substance use treatment within community mental health agencies has had an outsized impact on rural residents with co-occurring mental health and substance use problems, leading to increased barriers to treatment access and difficulties with maintaining care. Using data from an electronic health record repository for the years 2017 through 2019, this study examines one policy level approach that may facilitate integrated mental health and substance use service delivery within a community mental health system made up of agencies that have integrated services to varying degrees. Testing a fee-for-service and capitated payment blended payment model for Medicaid payments in a primarily rural state, this study assesses the impact of the model on the odds of service users with co-occurring disorders accessing care and completing treatment. Paper 1 estimates the odds of service users receiving co-occurring care after the initiation of the blended payment model. Paper 2 estimates the odds of service users within adult mental health and substance use treatment programs receiving co-occurring diagnoses after the blended payment model is initiated. Paper three tests the odds of service users with co-occurring disorders utilizing Medicaid as an insurer completing treatment compared to non-Medicaid users after the initiation of the blended payment model. Paper 1 findings showed no change in the odds of receiving cooccurring services after initiation of a blended payment model. Paper 2 findings showed increased odds of service users receiving co-occurring diagnoses in the least integrated agencies. Paper 3 findings show decreased odds of a service user with co-occurring disorders on Medicaid completing treatment after the implementation of a blended payment model. These findings provide initial insight into the impact of blended payment models on behavioral healthcare service delivery, and suggest that for care access and quality to be improved through integration of services, financial incentives may have limited utility in isolation from additional implementation strategies.

Subject Added Entry-Topical Term  

Social work.

Subject Added Entry-Topical Term  

Mental health.

Subject Added Entry-Topical Term  

Clinical psychology.

Index Term-Uncontrolled  

Blended payments

Index Term-Uncontrolled  

Integrated care

Index Term-Uncontrolled  

Rural behavioral health

Index Term-Uncontrolled  

Substance use disorders

Added Entry-Corporate Name  

New York University PhD Program

Host Item Entry  

Dissertations Abstracts International. 86-02B.

Electronic Location and Access  

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Control Number  

joongbu:657879