Article

Administration and Policy in Mental Health and Mental Health Services Research

, Volume 34, Issue 6, pp 548-562

Assessment, Authorization and Access to Medicaid Managed Mental Health Care

  • Mary C. MaslandAffiliated withDepartment of Psychology, Center for Mental Health Services Research, Institute of Personality and Social Research, University of California Email author 
  • , Lonnie R. SnowdenAffiliated withDepartment of Psychology, Center for Mental Health Services Research, Institute of Personality and Social Research, University of CaliforniaSchool of Social Work, University of California
  • , Neal  T. WallaceAffiliated withHatfield School of Government, Portland State University

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Abstract

Examined were effects on access of managed care assessment and authorization processes in California’s 57 county mental health plans. Primary data on managed care implementation were collected from surveys of county plan administrators; secondary data were from Medicaid claims and enrollment files. Using multivariate fixed effects regression, we found that following implementation of managed care, greater access occurred in county plans where assessments and treatment were performed by the same clinician, and where service authorizations were made more rapidly. Lower access occurred in county plans where treating clinicians authorized services themselves. Results confirm the significant effects of managed care processes on outcomes and highlight the importance of system capacity.

Keywords

Managed care Access Medicaid System capacity