New Systems To Manage Mental Health Care

England, Mary Jane; Vaccaro, Veronica A.

doi:10.1377/hlthaff.10.4.129

Cited by 21 publications

(10 citation statements)

References 5 publications

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“…Managed care, including prior authorization, concurrent review, case management, and their hybrids, is a rapidly evolving field in both health and mental health services. 23 If inappropriate use of health services can be forestalled by managed care in a cost-effective way, payment incentives to patients and providers can be relaxed. The strongest evidence favoring managed mental health care arrangements shows a sizable impact on use of services by less severely ill cases and those not treated for substance abuse.…”

Section: Model Mental Health Benefit 105mentioning

confidence: 99%

A Model Mental Health Benefit in Private Health Insurance

Frank¹,

Goldman²,

McGuire³

1992

Health Affairs

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Section: Model Mental Health Benefit 105mentioning

confidence: 99%

A Model Mental Health Benefit in Private Health Insurance

Frank¹,

Goldman²,

McGuire³

1992

Health Affairs

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“…There is little consensus regarding the positive and negative influences associated with managed behavioral health care, especially for publicly funded services. Some analysts suggest that a well-developed managed care program can enhance access to mental health and substance abuse treatment and maintain the quality of care (England and Vaccaro 1991;Boyle and Callahan 1995;Callahan et al 1995;Hellinger 1998). Other reviewers, however, believe that managed care is biased toward poor care because financial incentives may reward reductions in services (Kassirer 1995;Woolhandler and Himmelstein 1995;Schlesinger, Dorwart, and Epstein 1996).…”

Section: Discussionmentioning

confidence: 99%

Methadone Maintenance and State Medicaid Managed Care Programs

McCarty

Frank

Denmead³

1999

Milbank Quarterly

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Coverage for methadone services in state Medicaid plans may facilitate access to the most effective therapy for heroin dependence. State Medicaid plans were reviewed to assess coverage for methadone services, methadone benefits in managed care, and limitations on methadone treatment. Medicaid does not cover methadone maintenance medication in 25 states (59 percent). Only 12 states (24percent) include methadone services in Medicaid managed care plans. Moreover, two of the 12 states limit coverage for counseling or medication and others permit health plans to set limits. State authorities for Medicaid and substance abuse can collaborate to ensure that appropriate medication and treatment services are available for Medicaid recipients who are dependent on opioids andto construct payment mechanisms that minimize incentives that discourage enrollment among heroin‐dependent individuals.

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“…In 1990, at the same time that health care costs for purchasers/employers increased by 21%, costs for mental health and substance abuse services increased as much as 60% (15). By the end of 1995, more than 60% of Americans belonged to some form of managed health care plan.…”

Section: The Arrival Of Managed Carementioning

confidence: 99%

“…States established capitated contracts with HMOs as well as private behavioral health corporations to provide mental health-related services to people with serious, persistent mental disorders. This includes authorization of services like adult day treatment or partial hospitalization in order to achieve the most cost-effective outcomes for patients who are high utilizers (15).…”

Section: The Arrival Of Managed Carementioning

confidence: 99%

“…Their performance targets, which are almost always negotiated as part of vendor contracts, are specific and binding. The databases they have built to track their patient population are of undocumented quality, but they probably have more comprehensive data than can be found in most other domains of the health care system (15).…”

Section: Severe Limitations On What We Knowmentioning

confidence: 99%

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Mental Health and Managed Care

Durham

1998

Annu. Rev. Public Health

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▪ Abstract Managed care has become the dominant method for financing and delivering care for common mental health problems and for people with severe, chronic mental health conditions. Despite the rapid growth of managed mental health care, there is very little research available to guide policy choices. Managed care has led to decreased costs for employers and other payers, mostly through reducing hospital admissions or length of stay. Managed care organizations use staff with lesser levels of training (e.g. social workers instead of psychiatrists) and are more likely to offer group outpatient programs and manualized treatment than their fee-for-service counterparts. Despite these differences, there is no clear evidence that health outcomes are worse for patients in managed care. There is an urgent need for researchers to turn their attention to issues such as cost, quality, access, satisfaction, and functional outcomes associated with managed mental health care. The impact of parity of mental health with insurance coverage for physical conditions is another important question that needs to be addressed.

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New Systems To Manage Mental Health Care

Cited by 21 publications

References 5 publications

A Model Mental Health Benefit in Private Health Insurance

A Model Mental Health Benefit in Private Health Insurance

Methadone Maintenance and State Medicaid Managed Care Programs

Mental Health and Managed Care

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