Mental Health Services Research

, Volume 2, Issue 1, pp 13–25

Refining the Costs Analyses of the Fort Bragg Evaluation: The Impact of Cost Offset and Cost Shifting

  • E. Michael Foster
  • Leonard Bickman

DOI: 10.1023/A:1010139823791

Cite this article as:
Foster, E.M. & Bickman, L. Ment Health Serv Res (2000) 2: 13. doi:10.1023/A:1010139823791


A key aim of the evaluation of the Fort Bragg Demonstration was to determine whether delivering services through a continuum of care lowered expenditures on mental health services. The evaluation clearly showed that expenditures were actually higher in the Demonstration. Critics of the evaluation claimed that the evaluation's perspective on costs was too narrow—in particular, that the Demonstration produced cost shifting and cost offset that were not captured by the evaluation. New data allow us to include a broader array of costs: mental health services received outside the catchment areas, general medical services for the children themselves, and mental health services used by family members. Results showed that reductions in other costs do partially offset higher expenditures on mental health services for children at the Fort Bragg Demonstration. However, even when broader costs are included, total family expenditures are still substantially higher at the Demonstration.


Copyright information

© Plenum Publishing Corporation 2000

Authors and Affiliations

  • E. Michael Foster
    • 1
  • Leonard Bickman
    • 2
  1. 1.School of Policy StudiesGeorgia State UniversityAtlanta
  2. 2.Center for Mental Health PolicyVanderbilt UniversityNashville