Impact of Serious Mental Illness on Medicaid and Other Public Healthcare Costs in Texas

  • Paul RowanEmail author
  • Charles Begley
  • Shuangshuang Fu
  • Bakbergen Turibekov
  • Robert Morgan
Original Article


Medicaid-enrolled adults with serious mental illness may be dually-enrolled in Medicare, and may receive health care services from other state and local programs. To understand cross-program costs of care, we linked 2012 payment data across Medicaid, Medicare, state, and local programs. Average costs were calculated according to presence/absence of SMI, Medicare coverage, SSI coverage, medical comorbidities, and other characteristics. Costs for Medicaid adults with SMI were 57.4% greater than adults without SMI, but only 23.6% of costs were SMI-related. Greater costs were associated with Medicaid-Medicare dual-eligibility, multiple SMI diagnoses, and medical comorbidities. The results support cross-program efforts such as joint Medicaid-Medicare managed care and integrated care.


Serious mental illness Medicaid Costs Texas Integrated care 



Funding was provided by Meadows Foundation (US).

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflict of interest.

Ethical Approval

This research project was approved by the Institutional Review Board at the University of Texas Health Science Center. This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Management, Policy, and Community HealthThe University of Texas-Houston School of Public HealthHoustonUSA
  2. 2.Department of Epidemiology, Human Genetics and Environmental SciencesThe University of Texas-Houston School of Public HealthHoustonUSA
  3. 3.Division of Management, Policy, and Community HealthThe University of Texas- Houston School of Public HealthHoustonUSA

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