Medicaid And Mental Health: Be Careful What You Ask For

The Health Care Financing Maze for Working-Age People with Disabilities

“…As states devote a higher portion of their mental health funds to meeting Medicaid match requirements, states' ability to maintain or expand mental health/substance abuse programs for a growing population of low-income uninsured people is becoming increasingly constrained. Thus, the consequence of the growth in Medicaid spending for mental health over the past 30 years appears to be a reduction in the discretionary funds for states to attend to the traditional safety-net function of the state mental health agency (Frank et al,2003).…”

Accomplishments And Challenges In Medicaid Mental Health

“…3 By 1997 Medicaid was a major payer in the mental health system, accounting for 36 percent of the $48 billion in public mental health funds spent in 1997. 4 Mental health spending, exclusive of prescription drug costs, now accounts for 10 percent of total Medicaid spending.…”

Cooperation and Compromise: A Network Response to Conflicting Institutional Pressures in Community Mental Health

“…The rational choice view is also not consistent with efforts to encourage providers to collaborate as well as contain costs, which does, however, fit with a reinterpretation of the principal-agent variety of rational choice theory contained in the literature in the new economics of organization (Miller, 1992;Moe, 1984). The impact of managed care on both cost containment and collaboration between service providers is an important issue for mental health policy, especially because most states now utilize some form of managed care for at least part of their Medicaid behavioral health plans (Frank et al, 2003). If managed care actually discourages cooperation between providers, it could save money for states in the short run but have a significant long-term negative impact on the quality of care clients receive thus creating outcomes that are efficient but not effective.…”

“…Boyle & Callahan, 1995;Mechanic & McAlpine, 1999). There have also been many studies that have addressed mental health financing (e.g., Frank, Goldman, & Hogan, 2003) and clinical treatment and utilization patterns (e.g., Morrissey, Stroup, Ellis, & Merwin, 2002) under managed care. But very few studies have focused on the impact of managed care on mental health system structure and the formation of network relations, especially those operating under full-risk arrangements.…”