Implementing capitation of medicaid mental health services in Colorado: Is “readiness” a necessary condition?

  • Joan R. Bloom
  • Kelly Devers
  • Neal T. Wallace
  • Nancy Wilson
Brief Reports

Abstract

Two consortia of community mental health centers in Colorado varied in their administrative readiness for changing to a capitated system and, ultimately, implemented capitation using different organizational arrangements. The objective was to assess the impact of this natural experiment on administrative change, costs, and utilization of services during the first two years postcapitation. Prior to capitation, one was rated as having greater “readiness” than the other and received a capitation contract from the state, while the other did not. A private, for-profit managed behavioral health organization was awarded a contract and formed a joint venture with the less “ready” consortium, providing managed care expertise to complement the consortium's expertise in delivering mental health services. Two years later, these consortia do not look different either administratively or in their patterns of service utilization and costs. These findings suggest alternative ways of successfully implementing a capitated public mental health system.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Kaiser Commission on the Future of Medicaid: Medicaid and Managed Care: Lessons from the Literature. Washington, DC: Kaiser Commission on the Future of Medicaid, 1995.Google Scholar
  2. 2.
    Coughlin TA, Ku L, Holahan J:Medicaid since 1980: Costs, Coverage, and the Shifting Alliance between the Federal Government and the States. Washington, DC: Urban Institute Press, 1994.Google Scholar
  3. 3.
    Frank RG, Gaynor M: State government choice of organizational structure for local mental health system: An exploratory analysis. In: Scheffler R, Rossiter L (Eds.):Advances in Health Economics and Health Services Research. Greenwich, CO: JAI, 1993, No.14, pp.181–196.Google Scholar
  4. 4.
    Manderscheid R, Sonnenschein MA (Eds.):Mental Health, United States, 1992. Pub. No. SMA 94-3000. Washington, DC, 1994.Google Scholar
  5. 5.
    Division of Mental Health:Capitating Medicaid Mental Health Services in Colorado: A Feasibility Study. Denver: Colorado Department of Institutions, 1992.Google Scholar
  6. 6.
    Daft RL:Organization Theory and Design. Cincinnati, OH: South-Western College Printing, 1997.Google Scholar
  7. 7.
    Calahan JJ, Shepard DS, Beinecke RH, et al.: Mental health substance abuse treatment in managed care: The Massachusetts Medicaid experience.Health Affairs 1995; 14:173–184.Google Scholar
  8. 8.
    Christianson J, Manning W, Lurie N, et al.: Utah's prepaid mental health plan: The first year.Health Affairs 1995; 14:160–172.Google Scholar
  9. 9.
    Bloom JR, Hu TW, Wallace N, et al.: Mental health costs and outcomes under alternative capitation systems in Colorado: Early results.Journal of Mental Health Policy and Economics 1998; 1:3–13.Google Scholar
  10. 10.
    Bloom JR, Hu TW, Wallace N, et al.:Mental Health Access and Costs under Alternative Capitation Systems in Colorado: Second Year Results. Paper presented at the biennial NIMH meeting of Mental Health Economics, Washington, DC, 1998.Google Scholar
  11. 11.
    Hausman J, Wallace N, Bloom JR: Managed mental health experience in Colorado. In: Mechanic D (Ed.):Managed Behavioral Health Care: Current Realities and Future Potential. San Francisco: Jossey-Bass, Summer 1998, No. 78, pp. 107–114.Google Scholar

Copyright information

© Association of Behavioral Healthcare Management 2000

Authors and Affiliations

  • Joan R. Bloom
    • 1
  • Kelly Devers
    • 2
  • Neal T. Wallace
    • 3
  • Nancy Wilson
    • 4
  1. 1.Health Policy and ManagementUniversity of CaliforniaBerkeley, Berkeley
  2. 2.the Center for Studying Health System ChangeUSA
  3. 3.the Mark Hatfield School of Public PolicyPortland State UniversityUSA
  4. 4.Mental Health ServicesState of ColoradoUSA

Personalised recommendations