Use of Psychotropic Medications among Medicaid Beneficiaries

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June 2015

Psychotropic medications play a clinically established role in behavioral health treatment, and the use of psychotropic medications among Medicaid beneficiaries is substantial. In 2011, almost half of children and adults who qualified for Medicaid on the basis of disability and nearly a quarter of children eligible based on child welfare assistance used psychotropic medications, compared to 21 percent of adults eligible on a basis other than disability and 5 percent of children eligible on a basis other than child welfare or disability.  Medicaid spent about $8 billion in fee-for-service claims for psychotropic medications in 2011—30 percent of the program’s total fee-for-service drug spending.

Chapter 5 examines psychotropic drug use in Medicaid, reviewing overall psychotropic medication use and spending in Medicaid by eligibility group, current prescribing guidelines, and concerns as to whether the high proportion of Medicaid enrollees with multiple psychotropic prescriptions is appropriate.  The chapter concludes by describing federal and state activities aimed at improving the use of psychotropic medications, particularly for children in foster care and older adults with dementia.

Publication Type: Reports to Congress

From: June 2015 Report to Congress on Medicaid and CHIP

Tags: adults age 19-64, behavioral health, benefits, children, dually eligible beneficiaries, elderly, fee for service, foster children, managed care, people with disabilities, people with mental illness, prescription drugs, spending