When evaluating the effectiveness managed care programs in meeting their policy goals, it is critical that we fully understand the impacts of these programs on costs and outcomes. Often, cost analyses are restricted to the budgeted costs that are directly associated with care rather than to the broader cost implications for all of the formal and informal venues in which persons receive assistance. Findings will be summarized from a social cost analysis of 688 adults with severe mental illness enrolled in one of three Medicaid health/mental health insurance arrangements in Florida (i.e., a mental health carve-out, a carve-in, and fee-for-service). Self-report service utilization data were collected on a bi-monthly basis over a 15-month period. Over 3,100 interviews were completed. Information included the frequency and intensity of use of both formal (e.g., clinic services) and informal services (e.g., self-help groups, family assistance) from the full spectrum of community resources (e.g., mental health, corrections, family). Preliminary analyses show important differences among insurance conditions in service utilization patterns. For example, enrollees in the two managed mental health conditions reporting significantly more supports from family and friends (87% and 93%) compared to enrollees in the fee-for-service condition (33%). The effects of informal care substitutions as well as other ‘off budget’ service utilization will be discussed in the context of limited outcome differences between the plans. It is only through this comprehensive evaluation of costs and outcomes that we can adequately evaluate the impacts of managed care insurance programs for these vulnerable populations.
Learning Objectives: Participants will be able to describe how the financial arrangments of mental health services is associated with service substitution effects and overall social costs.
Keywords: Managed Care, Cost Issues
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.