Special Section: Public/Private Collaboration In Managing Behavioral Health Services

The Journal of Behavioral Health Services & Research

, Volume 25, Issue 3, pp 279-292

First online:

Privatized medicaid managed care in massachusetts: Disposition in child and adolescent mental health emergencies

  • Joanne NicholsonAffiliated withCenter for Psychosocial and Forensic Services Research, Department of Psychiatry, University of Massachusetts Medical School Email author 
  • , Stephen Dine YoungAffiliated withCenter for Psychosocial and Forensic Services Research, Department of Psychiatry, University of Massachusetts Medical School
  • , Lorna J. SimonAffiliated withCenter for Psychosocial and Forensic Services Research, Department of Psychiatry, University of Massachusetts Medical School
  • , William H. FisherAffiliated withCenter for Psychosocial and Forensic Services Research, Department of Psychiatry, University of Massachusetts Medical School
  • , Anne BatemanAffiliated withNortheastern University

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Abstract

Data from child and adolescent emergency mental health screening episodes prior and subsequent to privatized Medicaid managed care in Massachusetts are used to investigate the relationship between payer source and disposition and to compare the match between clinical need and disposition level of care. Having Medicaid as the payer in the post-Medicaid managed care period decreased the odds of hospitalization by nearly 60%. None of the clinical need variables that contributed to hospitalization for Medicaid episodes in the pre-Medicaid managed care period were significant in the post-Medicaid managed care period. Multiple forces shaping professional standards, decision making, and quality of care are described. Public sector agencies must lay the groundwork for comprehensive evaluation prior to the implementation of privatized Medicaid managed care initiatives.