Recorded presentation

Jenny K. Hyun, MPH, Health Services and Policy Analysis, School of Public Health, University of Califoria, Berkeley, Institute for Mental Health Services, 140 Warren Hall, University of California, Berkeley, CA 94720-7360, 510-642-2853, jhyun@uclink.berkeley.edu, Janet M. Coffman, MPP, MA, Health Services & Policy Analysis, School of Public Health, University of California, Berkeley, 2140 Shattuck Avenue, Suite 309, Berkeley, CA 94720-5610, Soo H Kang, DrPH, Center for Mental Health Services Research - School of Public Health, University of California, Berkeley, 2140 Shattuck Avenue, Suite 309, Berkeley, CA 94720-5610, and Joan R. Bloom, PhD, Health Policy and Management, School of Public Health, University of California, Berkeley, 2140 Shattuck Avenue, Suite 309, Berkeley, CA 94720-5610.

Introduction: Many states are experiencing budget crises that are leading to deep cuts in Medicaid and other programs that fund mental health services for low-income persons. In the thirty-six states in which Medicaid pays for services on capitated basis, managers of organizations that receive capitation payments have discretion regarding the manner in which cuts are allocated across capitated services. In some states, such as Colorado, these decisions are especially challenging because previous policy encouraged providers to use “savings” from generous capitation payments to expand services.

Aim: To determine how mental health providers in Colorado that serve Medicaid enrollees and other low-income persons are responding to cuts in state mental health spending.

Methods: A survey was administered to managers of eight organizations that have capitated contracts with Colorado’s Medicaid program for mental health services and to the state’s 17 community mental health centers (CMHCs). Topics addressed include changes in the number of clients served, number of sites, types of services provided, appeals and grievances, wait times, staffing, and strategies for managing utilization.

Hypotheses: We hypothesize that capitated agencies and CMHCs have expanded utilization management efforts, consolidated services at a smaller number of sites, and concentrated cuts among the most costly types of services and personnel.

Findings: Our survey is in the field and we expect to have final results prior to the APHA annual meeting.

Implications: Our findings are likely to be of interest to mental health professionals, managers, and policymakers concerned about access to mental health services for low-income persons.

Learning Objectives: At the end of this session, participants will be able to

• Discuss the financial challenges facing organizations that provide mental health services to low-income persons
• Describe the response of community mental health centers in Colorado to cuts Medicaid capitation rates and state funding for indigent care
• Discuss the study’s implications for policy and practice

Keywords: Mental Health Services, Financing

Presenting author's disclosure statement:
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.

Recorded presentation