A multi-site study of medicaid-funded managed care versus fee-for-service plans' effects on mental health service utilization of children with severe emotional disturbance

  • Judith A. Cook
  • Genevieve Fitzgibbon
  • Jane Burke-Miller
  • Melissa Williams
  • Jong-Bae Kim
  • Craig Anne Heflinger
  • Christina W. Hoven
  • Kelly J. Kelleher
  • Virginia Mulkern
  • Robert I. Paulson
  • Al Stein-Seroussi
Regular Articles

Abstract

Although Medicaid-funded managed care arrangements are commonly used in the delivery of mental health and substance abuse services to low-income children and youth, little is known about the effectiveness of such efforts. This article examines differences in mental health services utilization between children and youth with severe emotional disturbance covered by Medicaid-funded managed care behavioral health plans and those covered by fee-for-service plans. Data are from a federally funded multi-site study. In multivariate analyses controlling for child and caregiver demographic and clinical factors, enrollment in a managed care behavioral health plan was associated with lower inpatient/residential, psychiatric medication, and nontraditional services utilization. No difference was found in outpatient services utilization. Medicaid-funded managed care behavioral health plans appear to reduce use of some types of mental health services, but it is important to address the question of whether low-income children's enrollment in such programs deprives them of needed services.

Keywords

Mental Health Substance Abuse Health Promotion Mental Health Service Health Psychology 

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Copyright information

© Association of Behavioral Healthcare Management, NCCBH 2004

Authors and Affiliations

  • Judith A. Cook
    • 1
  • Genevieve Fitzgibbon
    • 1
  • Jane Burke-Miller
    • 1
  • Melissa Williams
    • 1
  • Jong-Bae Kim
    • 1
  • Craig Anne Heflinger
    • 2
  • Christina W. Hoven
    • 3
  • Kelly J. Kelleher
    • 4
  • Virginia Mulkern
    • 5
  • Robert I. Paulson
    • 6
  • Al Stein-Seroussi
    • 7
  1. 1.Department of Psychiatry, Center on Mental Health Services Research and PolicyUniversity of Illinois at ChicagoChicago
  2. 2.Vanderbilt UniversityNashville
  3. 3.The International Center for Child and Adolescent Mental Health in the Department of Epidemiology in the Mailman School of Public Healthand Child and Adolescent Psychiatry in the College of Physicians and Surgeons at Columbia UniversityNew York
  4. 4.Clinical Sciences at the Columbus Children's Research Institute and professor of pediatrics at the Ohio State UniversityColumbus
  5. 5.Human Services Research InstituteCambridge
  6. 6.The Louis de la Parte Florida Mental Health Institute at the University of South FloridaTampa
  7. 7.The Pacific Institute for Research and EvaluationChapel Hill

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