Planning Patient-Centered Health Homes for Medicaid Psychiatric Patients at Greatest Risk for Intensive Service Use

Joyce C. West, Donald S. Rae, Ramin Mojtabai, Farifteh F. Duffy, Janet Kuramoto, Eve Moscicki, William E. Narrow

Research output: Contribution to journalArticle


This study identified characteristics of Medicaid psychiatric patients at risk of hospitalizations and emergency department (ED) visits to identify their service delivery needs. A total of 4,866 psychiatrists were randomly selected from the AMA Physician Masterfile; 62 % responded, 32 % met eligibility criteria and reported on 1,625 Medicaid patients. Patients with schizophrenia, substance use disorders, suicidal and violent ideation/behavior, and psychotic, substance use, or manic symptoms were at high risk for intensive service use, along with homeless and incarcerated patients. Patients with schizophrenia or psychotic symptoms represented 37 % of patients, but used 73 % of all hospital days and 61 % of all ED visits. Patients with substance use problems comprised 21 % of patients, but used nearly half of all ED visits. Our findings highlight opportunities to enhance treatments and interventions, and inform the development of patient-centered health homes to address the needs of patients at high risk for intensive service use.

Original languageEnglish (US)
Pages (from-to)513-522
Number of pages10
JournalCommunity Mental Health Journal
Issue number5
StatePublished - Jul 23 2015



  • Care management
  • Emergency department
  • Health homes
  • Hospitalization
  • Medicaid

ASJC Scopus subject areas

  • Health(social science)
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental health

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