Overview Of Publicly Funded Managed Behavioral Health Care

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Abstract

Using MEDLINE and other Internet sources, the authors perform a systematic review of published literature. A total of 109 articles and reports are identified and reviewed that address the development, implementation, outcomes, and trends related to Managed behavioral health care (MBHC). MBHC remains a work in progress. States have implemented their MBHC programs in a number of ways, making interstate comparisons challenging. While managed behavioral health care can lower costs and increase access, ongoing concerns about MBHC include potential incentives to under-treat those with more severe conditions due to the nature of risk-based contracting, the tendency to focus on acute care, difficulties assuring quality and outcomes consistently across regions, and a potential cost-shift to other public agencies or systems. Success factors for MBHC programs appear to include stakeholder involvement in program and policy development, effective contract development and management, and rate adequacy.

Mardi Coleman, B.A., is a Research Associate at the UMass Center for Health Policy and Research. William Schnapp, Ph.D., is a Professor at the University of Texas Medical School at Houston. Debra Hurwitz, M.B.A., B.S.N., R.N., is the Director, Sabine Hedberg, M.A., M.P.A., is a Project Director, Linda Cabral, M.M., is a Project Director, and Aniko Laszlo, M.A., M.B.A., is a Research Associate, all at the UMass Center for Health Policy and Research. Jay Himmelstein, M.D., M.P.H., is a Professor of Family Medicine and Community Health.
Material for this article was developed in part to support a comprehensive evaluation of the MassHealth Primary Care Clinician Plan behavioral health carve-out, conducted by the University of Massachusetts Center for Health Policy and Research at the request of Phyllis Peters, M.B.A., Deputy Assistant Secretary for the MassHealth Office of Acute and Ambulatory Care.
Address for correspondence: Mardi Coleman, B.A., UMass Center for Health Policy and Research, 222 Maple Avenue, Shrewsbury, MA 01545. E-mail: mardia.coleman@umassmed.edu.