Since the 1970's, managed care approaches have been used to control spiraling costs of Medicaid health care services, and more recently, of mental health care services. However, few large-scale studies have addressed the effectiveness of such efforts. This 5-site multicenter study examined whether mental health status and service utilization of children and youth with severe emotional disturbance (SED) differed significantly for those covered by Medicaid-funded managed care versus those covered under fee-for-service plans. Interviews with children and their adult caregivers were conducted at baseline and 6-month follow-up, and Medicaid claims and shadow-claims data for these children were obtained. Mental health status was assessed by the Columbia Impairment Scale, and the Child Behavior Checklist. Although children in both types of plans had better mental health status at follow-up, there were no significant differences controlling for behavioral heath care need at baseline, child characteristics, adult caregiver features, household/neighborhood characteristics, and study site. In similar models, children in the managed care plans were significantly less likely to use inpatient and non-traditional services, with a trend toward less use of psychiatric medications. There were virtually no differences in use of outpatient services between children in managed care versus fee-for-service plans. As with other health care services, managed care seems to reduce utilization of some behavioral services, particularly inpatient and complementary services, with little effect on outcome.
Learning Objectives: At the conclusion of this session, the participant will be able to: Articulate the findings of prior research regarding the effects of managed care on children's utilization of mental health services. Describe the effects of managed care on the outcomes and service utilization of children with severe emotional disturbance (SED) in a recently-concluded multicenter study. Describe different types of managed care arrangements and how their effects on SED children's mental health service utilization and outcomes vary.
Keywords: Child/Adolescent Mental Health, Managed Care
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
Disclosure not received
Relationship: Not Received.