This report, based on the National Survey of Drug Use and Health (NSDUH), found that, in 2007, 8.2 percent of adolescents (an estimated 2.0 million youths aged 12 to 17) experienced at least one major depressive episode (MDE) in the past year, and about two fifths (38.9 percent) of those received treatment for depression in the past year. Among adolescents with past year MDE, those with no health insurance coverage were much less likely than those with Medicaid/Children's Health Insurance Program or private health insurance to have received treatment (17.2 vs. 42.9 and 40.6 percent, respectively). 

Download the report from SAMHSA's OAS here: http://www.oas.samhsa.gov/2k9/youthDepression/MDEandTXTforADOL.pdf 

The article explores the shift in prescription coverage for dual eligible mental health patients from Medicaid to Medicare Part D in 2006.  The authors note that a reduction in the number of plans and increases utilization of psychotropic drugs raises concerns about access to medication for individuals with mental illness.  The authors suggest possible changes to Medicare's enrollment and risk-sharing systems. 

Donohue, J. M., H. A. Huskamp, et al. (2009). Dual eligibles with mental disorders and Medicare part D: how are they faring? Health Affairs, 28(3), 746-59. DOI: 10.1377/hlthaff.28.3.746 http://content.healthaffairs.org/cgi/content/abstract/28/3/746 

This article assessed Medicaid physician fees between 2003 and 2008.  On average, fees increased 15.1 percent which was below the rate of general inflation and resulted in a reduction in real fees.  Medicaid fees closed a small portion of their gap relative to Medicare fees, resulting from increases in primary care and obstetrics. 

Zuckerman, S., A. F. Williams, et al. (2009). Trends in Medicaid physician fees, 2003-2008. Health Affairs, 28(3), w510-9. DOI: 10.1377/hlthaff.28.3.w510 http://content.healthaffairs.org/cgi/content/abstract/28/3/w510 

Authors: Stephen Zuckerman, Aimee F. Williams, Karen E. Stockley.

Using data from Southeastern Medicaid programs, this paper finds that, unlike with primary care, the impact of managed care settings on mental health provider satisfaction is minimal.  The authors note that variables relevant to everyday working conditions had important effects on job satisfaction. 

Isett, K. R., A. R. Ellis, et al. (2009). Managed care and provider satisfaction in mental health settings. Community Ment Health J., 45(3), 209-21. http://www.ncbi.nlm.nih.gov/pubmed/19002581 

Authors: Kimberley R. Isett, Alan R. Ellis, Sharon Topping, Joseph P. Morrissey.

This study examined the effects of prior authorization for second-generation anti-psychotic and anti-convulsant on utilization, discontinuations in therapy, and pharmacy costs among Maine Medicaid beneficiaries with bipolar disorder.  The study found that the prior authorization policy resulted in an 8 percent the prevalence of use of non-preferred second generation drugs but did not increase the rate of use for preferred drugs or the rate of switching.  The policy reduced total pharmacy reimbursements for bipolar disorder by $27 per patient during the eight-month policy period but the hazard rate of treatment discontinuation was higher than during the pre-policy period.  The authors conclude that the use of prior authorization in Maine may have increased patient risk without significant cost savings to the Medicaid program. 

Zhang, Y., A. S. Adams, et al. (2009). Effects of prior authorization on medication discontinuation among Medicaid beneficiaries with bipolar disorder. Psychiatric Services, 60(4), 520-7.  DOI: 10.1176/appi.ps.60.4.520 http://psychservices.psychiatryonline.org/cgi/content/abstract/60/4/520 

Authors: Yuting Zhang, Alyce S. Adams, Dennis Ross-Degnan, Fang Zhang, Stephen B. Soumerai. 

This articles examines the use of a controversial prior authorization policy in the Michigan Medicaid program on antidepressant use and and health outcomes for dually eligible Medicaid and Medicare enrollees with a Social Security Disability Insurance designation of permanent disability.  The study found that prior authorization was associated with increased use of preferred drugs with no evidence of adverse events among new users; however, there were unintended effects on treatment initiation and switching among patients already taking the drug. 

Adams, A. S., F. Zhang, et al. (2009). Prior authorization for antidepressants in Medicaid: effects among disabled dual enrollees. Arch Intern Med., 169(8), 750-6.  http://archinte.ama-assn.org/cgi/content/abstract/169/8/750

Authors: Alyce S. Adams, Fang Zhang, Robert F. LeCates, Amy Johnson Graves, Dennis Ross-Degnan, Daniel Gilden, Thomas J. McLaughlin, Christine Lu, Connie M. Trinacty, Stephen B. Soumerai.