Managing Eating Disorders Within Medicaid-Funded Health Care Systems in California

Area of Science:

• Public health
• Behavioral health systems
• Eating disorder management

Background:

• Publicly-funded behavioral health systems face unique challenges in managing patients with eating disorders (EDs).
• Current management practices within these systems are not well-documented, particularly concerning capacity and access to care.

Purpose of the Study:

• To describe the current management of patients with EDs within publicly-funded Medicaid behavioral health systems.
• To identify challenges and lessons learned in providing ED treatment within these systems.

Main Methods:

• Qualitative content analysis of meeting notes from behavioral health leaders across nine California counties.
• Quarterly meetings focused on sharing experiences, challenges, and lessons in ED management.

Main Results:

• Significant challenges include insufficient outpatient capacity and difficulties in building treatment capacity for EDs.
• Facilitating admission to out-of-network higher levels of care presents extraordinary challenges and high costs.
• Building an internal ED workforce is difficult due to training burdens, patient complexity, and clinician burnout.

Conclusions:

• There is a need for specialized ED treatment, case management, standardized processes, and centralized resources in Medicaid-managed care.
• Protecting clinicians from burnout through support and incentives is crucial.
• Policy changes facilitating admission to and reimbursement for higher levels of care are recommended to reduce administrative burden and burnout.