The economic impact of capitated care for high utilizers of public mental health services: The los angeles PARTNERS program experience

  • Kanika Kapur
  • Alexander S. Young
  • Dennis Murata
  • Greer Sullivan
  • Paul Koegel
Articles

Abstract

Los Angeles PARTNERS, or “people achieving rehabilitation together need empowering respectful support,” is a treatment program that uses capitation to shift risk for treatment costs of high utilizers of public mental health services to private community-based treatment organizations. This analysis reveals two important findings from PARTNERS. First, the economic incentives created by capitation contributed to the disenrollment of PARTNERS clients; furthermore, factors such as not speaking English or Spanish or having schizophrenia increased the probability of disenrollment. Second, analyses of health costs for enrollees in the PARTNERS capitation program suggest that the program did not result in a change in total costs. However, the program increased the use of community-based care and increased treatment costs for clients with lower preprogram costs but decreased costs for the clients with high preprogram costs. These results suggest that future capitation programs for this severely ill population would benefit from using detailed clinical information to determine program eligibility and to set risk-adjusted capitation rates.

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Copyright information

© Association of Behavioral Healthcare Management 1999

Authors and Affiliations

  • Kanika Kapur
    • 1
  • Alexander S. Young
    • 2
    • 3
  • Dennis Murata
    • 4
  • Greer Sullivan
    • 5
    • 6
  • Paul Koegel
    • 1
  1. 1.RAND CorporationSanta Monica
  2. 2.the Department of PsychiatryUniversity of CaliforniaLos Angeles
  3. 3.Neuro-psychiatric Institute; Veterans Health Administration, West Los Angeles HealthCare Center; and the RAND Corporation in Santa Monica
  4. 4.the Los Angeles County Department of Mental HealthUSA
  5. 5.the Veterans Health Administration, Veterans Integrated Service Network in North Little Rock
  6. 6.the University of Arkansas for Medical ScienceLittle Rock

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