Idaho Medicaid-Funded PSR Costs Skyrocketed Ninefold in 10 Years 

A decade-long analysis of Medicaid-funded care reveals Idaho costs for PSR increased ninefold—from $8.3 million in 2001 to $76.1 million in 2012.

The official title is Psychosocial Rehabilitation Counselor, but they're better known as PSR workers. Simply put, they work with clients diagnosed with mental health or emotional disorders, but instead of clinical or inpatient treatment, they focus on their clients' well-being in social situations such as work, school or while shopping.

However, according to a new report from the Idaho Legislature's Office of Performance Evaluations, some Idaho caregivers are accused of "overreliance on or misuse of PSR," and it is a "major concern" for the Idaho Department of Health and Welfare. A decade-long analysis of Medicaid-funded care reveals Idaho costs for PSR increased ninefold—from $8.3 million in 2001 to $76.1 million in 2012. Additionally, the analysis showed during the summer of 2013, Idaho's Division of Medicaid "spent four times more for members to receive PSR than it spent on inpatient care."

In 2013, sensing PSR costs were reaching unsustainable levels, Idaho lawmakers directed IDHW to move outpatient behavioral health services to what they called "managed care" under the new Idaho Behavioral Health Plan, which went live in September 2013.

IDHW Director Dick Armstrong said the shift to what he called a "cost-effective, evidence-based system of behavioral health care" has not been easy for many Idaho caregivers. The new reports from OPE confirmed the changes "have negatively affected some of these providers," citing "a widespread lack of understanding of the department's choices leading up to managed care."

OPE's recommendation: More control, not only of outpatient services but inpatient, as well. OPE is asking for the Legislature's permission to conduct yet another formal evaluation to apply lessons learned "and improve its planning process for future efforts."

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