Older Adult Population Served by California’s Medi-Cal Specialty Mental Health Services Presented by BHC-CalEQRO at California Mental Health Planning Council Quarterly Meeting, San Jose, Ca April 20, 2017 Saumitra SenGupta, Ph.D., Executive Director Rachel Phillips, MS, Reporting Manager Behavioral Health Concepts, Inc.
Older Adult Data Analysis • Population Analyzed • Methodology • Age Groupings • Overall Results CY15 • Demographic Results CY15 • Gender Results CY15 • Service Category Results CY15 • ACA Results CY15 Behavioral Health Concepts, Inc.
POPULATION ANALYZED Define SDMC, Age breakouts, Medi-Medi, ACA Behavioral Health Concepts, Inc.
Older Adult Age Groupings • 55-59 • 60-64 • 65-69 • 70-74 • 75-79 • 80-84 • 85+ Behavioral Health Concepts, Inc.
METHODOLOGY Data comes from the 2015 SDMC and IPC approved claims. Overall population totals are unduplicated by client index number. Results by Service Type are unduplicated by services; such that one person with multiple services are included. Results by Region and Size follow the same method as Service Type to account for beneficiaries receiving services in multiple regions or those who move throughout the year. Behavioral Health Concepts, Inc.
CY15 Medi-Medi Population • Total unduplicated count age 55 and over is 69,087. • Medi-Medi in the CY15 total is 30,956. • Medi-Cal in the CY15 total is 38,131. Behavioral Health Concepts, Inc.
CY15 Medi-Medi Younger than 65 • Medi-Medi under age 65 is 15,347. • Medi-Cal under the age 65 is 35,172. Behavioral Health Concepts, Inc.
CY15 Medi-Medi Age 65 and Over • Medi-Medi age 65 and over is 15,609. • Medi-Cal age 65 over is 2,959. Behavioral Health Concepts, Inc.
OVERALL ANALYSIS Number of beneficiaries served aged 55 and older. Average approved SDMC dollars for 55 and older. Results at the Statewide, Region, and Size levels. Behavioral Health Concepts, Inc.
CY15 Older Adult Age Groups Served Age Group 30,000 • Ages 55-69 account for 55-59 28,854 60-64 the majority of older 65-69 70-74 adults who received 25,000 75-79 mental health services 80-84 21,660 85 + funded by SDMC in 20,000 2015. Beneficiaries Served • Age group 55-59 had 15,000 the largest number of individuals who 10,429 10,000 received services. • Ages 80 and beyond 5,000 4,315 had the fewest services 2,167 compared to the other 996 664 0 older adult age groups 55-59 60-64 65-69 70-74 75-79 80-84 85 + Behavioral Health Concepts, Inc.
CY15 Average Approved Claims by Older Adult Group $10,000 Age Group 55-59 • The average approved 60-64 claim amount between 65-69 70-74 the age groups ranges 75-79 from $3,188 to $4,574. 80-84 85 + • Age group 55-59 had the Average Approved Claims highest average approved $5,000 claims amount. $4,574 $4,524 $4,481 $4,170 $4,110 $3,786 • Age group 85+ had the $3,188 lowest average approved claims amount. $0 55-59 60-64 65-69 70-74 75-79 80-84 85 + Behavioral Health Concepts, Inc.
CY15 Older Adult Served by Region • The unduplicated Region 25,000 Los Angeles number of older 23,606 Southern adults served in CY15 Bay Area Central totals 69,087. Superior 20,000 • The number of older 16,861 adults served across 15,923 California’s regions is Beneficiaries Served 15,000 greatest in LA. • The Southern and Bay 10,000 9,508 Area regions have comparable numbers of beneficiaries served. 5,000 2,889 • Superior has the fewest number of 0 older adults served. Los Angeles Southern Bay Area Central Superior Behavioral Health Concepts, Inc.
CY15 Older Adult Average Approved Claims by Region • The CY15 Statewide average Region Bay Area $6,131 approved claim amount is Superior $6,000 Los Angeles $4,023. Southern Central $5,000 • The Bay Area has the greatest amount of average $4,021 approved claims for older $4,000 Average Approved Claims $3,562 adults, with the value of $3,207 $6,131. $3,012 $3,000 • The Central region has the $2,000 lowest amount of average approved claims for older adults, with the value of $1,000 $3,012. $0 Bay Area Superior Los Angeles Southern Central Behavioral Health Concepts, Inc.
CY15 Older Adult Served by Size 35,000 MHP Size Large • The number of older adults Very-Large 31,147 Medium served is greatest in the 30,000 Small Large Sized MHP’s. Small-Rural 25,000 • 23,606 Very-Large MHP (LA) served the second highest number 20,000 of beneficiaries. • 15,000 Small-Rural has the fewest number of older adults served. 9,767 10,000 5,000 3,297 968 Large Very-Large Medium Small Small-Rural Behavioral Health Concepts, Inc.
CY15 Older Adult Average Approved Claims by Size • The average approved MHP Size Medium $5,423 $5,500 claims amounts Large Very Large ($5,423) for older adults $5,000 Small is greatest in the in the Small-Rural $4,500 $4,242 Medium Sized MHP’s. $4,000 $3,562 • Large MHP has the Average Approved Claims $3,427 $3,500 second greatest amount $3,000 $2,890 of approved claims $2,500 dollars ($4,242). $2,000 • Small-Rural has the $1,500 lowest average approved claim amount $1,000 ($2,890) for older adults $500 served. $0 Medium Large Very Large Small Small-Rural Behavioral Health Concepts, Inc.
RACE/ETHNICITY ANALYSIS Total Served Age 55+ by Race Group Average Approved Claims Age 55+ by Race Group Total Served in each Older Age Group by Race Group Average Approved Claims in each Older Age Group by Race Group Age groups 75-79, 80-84, and 85+ have been removed from this section’s analysis to due HIPAA regulations. Behavioral Health Concepts, Inc.
CY15 Older Adults Served by Race/Ethnicity • 30,000 The number of White Racegrp White older adults served in 26,713 Other African-American CY15 was 26,713. 25,000 Hispanic Asian-Pacific Islander • Native American The number of African American 20,000 older adults served in Beneficiaries Served CY15 was 11,092. 15,000 • The number of 12,473 Hispanic older adults 11,092 10,709 served in CY15 was 10,000 10,709. 7,669 • 5,000 The number of Asian Pacific Islander older adults served in CY15 429 0 was 7,669. Asian-Pacific Native White Other African-Amer.. Hispanic Islander American • The number of Native American older adults served in CY15 was Behavioral Health 429. Concepts, Inc.
CY15 Older Adult Average Approved Claims by Race/Ethnicity • African American and White Racegrp $5,000 $4,749 African-American $4,701 Race/Ethnicity groups have the $4,623 White $4,447 highest and similar average $4,500 Other Native American approved claim amounts; $4,749 Asian-Pacific Islander $4,000 and $4,701. Hispanic $3,500 • Native American’s had an average $3,220 approved claim amount $3,108 $3,000 Average Approved Claims Amount comparable to African-Americans and Whites at a value of $4,623. $2,500 • Asian Pacific Islander’s had an $2,000 average approved claim amount of $3,220. $1,500 • Hispanic’s had the lowest average $1,000 approved claim amount at a value of $3,108. $500 • $0 Others’ had an average approved African-Am.. White Other Native Asian- Hispanic claim amount of $4,447. American Pacific.. Behavioral Health Concepts, Inc.
CY15 Beneficiaries Served by Age Group and Race/Ethnicity Racegrp Age Group Racegrp White White 55-59 10,749 Other Other 5,447 African-American African-American 5,595 Hispanic Hispanic 4,269 Asian-Pacific Islander Asian-Pacific Isla.. 2,613 Native American Native American 181 White 60-64 8,410 Other 4,035 African-American 3,436 Hispanic 3,005 Asian-Pacific Isla.. 2,607 Native American 167 White 65-69 4,347 Other 1,855 African-American 1,333 Hispanic 1,639 Asian-Pacific Isla.. 1,201 Native American 54 White 70-74 1,789 Other 671 African-American 449 Hispanic 835 Asian-Pacific Isla.. 559 Native American 12 0 2,000 4,000 6,000 8,000 10,000 12,000 14,000 Beneficiaries Served • In all age groups, White beneficiaries received the highest number of services. • In the age groups between 55-64, African-American beneficiaries received more services than Hispanic, and in age groups 65-74 Hispanics received more services than African-Americans. • Native-Americans received the fewest number of services in all age groups. • Asian Pacific Islander beneficiaries received the second to last number of services across all age groups. Behavioral Health Concepts, Inc.
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