Missouri hospitals to Medicaid officials: Address rising child suicide risk since managed care switch

The percentage of children in Missouri who reported thoughts of suicide or attempted suicide doubled after private insurers began managing the state's Medicaid program, according to a Missouri Hospital Association analysis cited by Kaiser Health News.

MHA's report studied how moving 160,000 low-income children from fee-for-service Medicaid to managed care in 2017 affected their risk for suicide. Roughly 2,000 children received inpatient mental health treatment before and after the change. While about 10 percent had suicidal thoughts or attempted suicide 90 days post-discharge before the change, the percentage rose to nearly 19 percent after the switch to managed care in 2017.

In addition, children admitted to psychiatric hospitals saw their length of stay drop from 10 days to seven following the change, according to KHN's review of the report.

While MHA acknowledged that other factors like social media, cyberbullying and lack of specialized mental healthcare access also could have affected the results, they still urged state Medicaid officials to investigate the findings.

Managed care plans represented by the Missouri Health Plan Association said they took the findings "very seriously," but called the report "fundamentally flawed."

"This study is not peer-reviewed, it is based on a very small sample size and was clearly commissioned to attempt to further a predetermined hypothesis," the association said in a statement to KHN.

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