Rutgers, The State University of New Jersey
Rutgers University Website Institute for Health, Health Care Policy and Aging Research

Center for Education and Research on Therapeutics (CERTs)

Antipsychotic Medication Use in Medicaid Children and Adolescents: Report and Resource Guide From a 16-State Study

Prepared by the Publication Committee:

State Medicaid
Mary Ellen Foti, M.D.; Gordon Harper, M.D.; Robert Moon, M.D.; George Oestreich, Pharm.D., M.P.A.; Roger Snow, M.D., M.P.H., Jeffery Thompson, M.D., M.P.H.

State Mental Health
Molly Finnerty, M.D.; Elsie Freeman, M.D.; Penny Knapp, M.D.; Nina Jo Muse, M.D.; Joseph Parks, M.D.

Rutgers CERTs
Stephen Crystal, Ph.D.; Tobias Gerhard, Ph.D.

Nancy Wilson, M.D., M.P.H.

Medicaid Medical Directors Learning Network/Rutgers CERTs
June 2010


The Resource Guide on improving quality in the management of antipsychotic use among Medicaid children, and its accompanying data dictionary and compendium of State practices, were motivated principally by the desire of the consortium to provide information that would be useful for State officials, across the nation, in their efforts to improve quality of mental health care for their Medicaid populations.  We hope that they will also be useful to others who are concerned with these aims.  Incorporating pooled results from States’ analyses of their antipsychotic and mental health drug use derived from claims data, this Resource Guide aims to provide information that can contribute to State efforts to assess the quality of care in their programs, across counties and prescribers, using quality improvement strategies best suited to State conditions.  The States mentioned in this guide gave permission to use their data for illustrative and comparative purposes so that others could learn by their examples.

The Resource Guide and compendium of practices were developed with the goal of contributing to the efforts of State leaders who struggle with quality improvement and facilitating the sharing of expertise, ideas, knowledge, and solutions.  The various sections may be of particular interest to different users.  For example, Sections 1, 4, and 6 may be most useful to senior leaders who are responsible for making the case for mental health quality improvement and taking action, while Sections 2, 3, and 5 may be most useful to program staff involved in developing and implementing specific quality improvement strategies.  The goal, of course, is that all groups work on these topics as a team.  It is within those discussions and sharing and working together we hope to achieve what we set out to do—help States improve the quality of mental health care and prescription drug use.

Many people for whom these learning tools were intended—State elected and appointed leaders as well as officials in State health departments, mental health and children’s programs, Medicaid offices, and other Medicaid officials and stakeholders—provided comments and feedback throughout the development and finalization process.   We offer our thanks to all the contributors for this input, and hope that they will use the Resource Guide, State Practices, and Data Dictionary in many different ways: to assess their current structure and status, to create new quality improvement programs, to build upon existing programs, and to share with their partners including consumer groups; managed care organizations; mental health clinics; and the clinicians who care for the often-vulnerable population of Medicaid beneficiaries.

For further information, contact:

Jeffery Thompson, M.D., M.P.H.
Chief Medical Officer
Washington State Medicaid
Olympia WA