The 131st Annual Meeting (November 15-19, 2003) of APHA

Abstract #65899

Wendy Holt, MPP, Dougherty Management Associates, Inc., 9 Meriam Street, Suite 4, Lexington, MA 02420, 781-863-8003, wendyh@doughertymanagement.com

The presenter will describe her work on the Medicaid Behavioral Health Benchmarking Project, sponsored by the Substance Abuse and Mental Health Services Administration (SAMHSA) and conducted under subcontract to The Lewin Group, Inc. This project collected behavioral health performance measures from 17 Medicaid managed care programs, including both integrated and carve-out models, and representing a wide variety of geographic areas, target populations and program designs. The presenter will discuss how the set of measures for collection were selected from multiple mental health measurement initiatives, and present data on several indicators, such as penetration, utilization, and cost. Examples from multiple Medicaid managed care plans will be shown, with discussion of the challenges involved in making useful comparisons across systems of care. The presenter will identify significant methodological issues, illustrate the significance of differences in target populations, and account for significant program parameters. The presentation will also highlight the potential value of cross-system comparisons for advocacy, policy development, and system management and reform, and the value of comparisons over time to measure the impact of current changes to state Medicaid programs.

Learning Objectives:

• At the conclusion of the session, participants will have access to performance measures from a variety of Medicaid managed care programs, understand their methodological issues, and recognize how significant differences in target populations and program parameters can limit the ability to make cross-system comparisons of performance. Participants will also recognize how such measures can be appropriately used for advocacy, policy development, and system management and reform, and how following such measures over time can measure the impact of current changes to state Medicaid programs.

Keywords: Adult and Child Mental Health, Managed Care

Related Web page: to be posted on SAMHSA's website shortly

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Certain HMOs and MBHOs operate the programs whose measures are included in this presentation
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.