Abstract
This study investigated how managed care affects clinical decision-making in a behavioral health care system. Providers serving children and adolescents under both managed and unmanaged care (n=28) were interviewed about their awareness of differences between the benefit arrangements, how benefits affect clinical decision-making, outcomes and quality of care; and satisfaction with care. Quantitative and qualitative findings indicated that providers saw both advantages and disadvantages to managed care. Although most providers recognized the advantages of managed care in increasing efficiency, many were concerned that administrative pressures associated with managed care compromise service quality.
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REFERENCES
Beinecke, R.H., & Lockhart, A. (1998). A provider assessment of the Massachusetts Medicaid Managed Behavioral Health Program: Year four. Administration and Policy in Mental Health, 25, 411-426.
Beinecke, R.H., & Woliver, R. (2000). Assessment of the Massachusetts Behavioral Health Program Year 6. Administration and Policy in Mental Health, 28, 107-129.
Friedman, R.M., Katz-Levy, J.W., Manderscheid, R.W., & Sondheimer, D.L. (1998). Prevalence of serious emotional disturbance: An update. Mental health, United States, 1998. Rockville, MD: U.S. Department of Health and Human Services.
Heflinger, C.A., & Northrup, D.A. (2000a). Community-level changes in behavioral health care following capitated contracting. Children and Youth Services Review, 22, 175-193.
Heflinger, C.A., & Northrup, D.A. (2000b). What happens when capitated behavioral health comes to town? The transition from the Fort Bragg Demonstration to a capitated managed behavioral health contract. The Journal of Behavioral Health Services and Research, 27, 390-405.
Lurie, N., Christianson, J.B., Gray, D.Z., Manning, W.G., & Popkin, M.K. (1998). The effect of the Utah Prepaid Mental Health Plan on structure, process, and outcomes of care. New Directions for Mental Health Services, 78, 99-105.
McCarthy, W.C., & Frieze, I.H. (1999). Negative aspects of therapy: Client perceptions of therapists' social influence, burnout, and quality of care. Journal of Social Issues, 55, 33-50.
Mechanic, D. (1999). Mental health and social policy: The emergence of managed care (4th ed.). Boston: Allyn and Bacon.
Mechanic, D. (2001). The managed care backlash: Perceptions and rhetoric in health care policy and the potential for health care reform. Millbank Quarterly, 79, 35-54.
Miller, R.H., & Luft, H.S. (1997). Does managed care lead to better or worse quality of care? Health Affairs, 16, 7-25.
Moutoussi, M., Gilmour, F., Barker, D., & Orrell, M. (2000). Quality of care in a psychiatric out-patient department. Journal of Mental Health, 9, 409-420.
Murphy, M.J., DeBernardo, C.R., & Shoemaker, W.E. (1998). Impact of managed care on the independent practice and professional ethics: A survey of independent practitioners. Professional Psychology: Research and Practice, 29, 43-51.
Popkin, M.K., Lurie, N., Manning, W., Harman, J., Callies, A., Gray, D., & Christianson, J. (1998). Changes in the process of care for Medicaid patients with schizophrenia in Utah's Prepaid Mental Health Plan. Psychiatric Services, 49, 518-523.
Russell, D.W., de la Mora, A., Trudeau, L.S., Scott, N.A., Norman, N.A., & Schmitz, M.F. (2000). Psychologists' reactions to Medicaid managed care: Opinion and practice change after one year. Professional Psychology: Research and Practice, 31, 547-552.
Sabin, J.E. (1998). Public-sector managed behavioral health care: I. Developing an effective case management program. Psychiatric Services, 49, 31-33.
Strauss, A., & Corbin, J.M. (1990). Basics of qualitative research: Grounded theory procedures and techniques. Thousand Oaks, CA: Sage.
Warner, R., & Huxley, P. (1998). Outcome for people with schizophrenia before and after Medicaid capitation at a community agency in Colorado. Psychiatric Services, 49, 802-807.
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Yanos, P.T., Garcia, C.I., Hansell, S. et al. Managed Care and Clinical Decision-Making in Child and Adolescent Behavioral Health: Provider Perceptions. Adm Policy Ment Health 30, 307–321 (2003). https://doi.org/10.1023/A:1024185216721
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DOI: https://doi.org/10.1023/A:1024185216721