Anecdotal evidence suggests that the Federal IMD exclusion has resulted in states opting to shift costs to the government by enacting inefficient Medicaid programs in order to gain federal reimbursement. The claim of “cost-shifting” relies on the assumption that state programs are inefficient – that is, that their Medicaid programs are less effective at reducing incarceration rates (as a metric for failure to properly treat) than their psychiatric hospitals. Literature in the Public Health, Psychiatric, and Criminal Justice fields was surveyed in order to determine relevant factors to be included in the model. Model variables include factors which contribute to mental illness, criminal data, and relevant state expenditures. Availability of data drove inevitable bias in selection of time frame and variables in multiple regressions using data from 2000 to 2010 across the fifty states. Upon analysis, the data do not support the claims made by the Treatment Advocacy Center that the IMD exemption has compromised the welfare of the Mentally Ill. However, the bias created by data selection is substantial enough to limit a conclusion of full support for the null; ultimately this study confirms the need for a more cross-sectional data on the subject.
Advisor(s) or Committee Chair
Dr. Michelle Trawick
Business | Economics
Rainey, Todd, "The Federal IMD Exemption and Cost-Shifting" (2011). Honors College Capstone Experience/Thesis Projects. Paper 316.