Suicide risk grew for Missouri kids after managed care shift

Abstract

After more than 2,000 Missouri children diagnosed with mental illness were shifted from traditional Medicaid into three for‐profit managed care companies, the state's hospitals noticed an alarming trend: a doubling in the percentage who had thoughts of suicide or attempted suicide, according to a study from the Missouri Hospital Association. The Medicaid change occurred in May 2017, Kaiser Health News reported April 1. The hospital association acknowledged that factors other than the move to managed care could have played a role behind the increase, including social media, cyberbullying and lack of access to specialized mental health care. The study looked at the impact of the state's shift of 160,000 low‐income children living in 61 mostly rural counties from traditional fee‐for‐service Medicaid to managed care in 2017. That included 2,152 children ages 5 to 19 who received inpatient mental health services before and after the switch to managed care. When these children were getting coverage through traditional Medicaid, about 10 percent had suicidal thoughts or made a suicide attempt in the 90 days after being discharged from an inpatient psychiatric hospital. That figure rose to nearly 19 percent after the move to managed care. Despite finding the study “fundamentally flawed,” the Missouri Health Plan Association added that it was taking the findings “very seriously.”