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.
References
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.
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.
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.
Manderscheid R, Sonnenschein MA (Eds.):Mental Health, United States, 1992. Pub. No. SMA 94-3000. Washington, DC, 1994.
Division of Mental Health:Capitating Medicaid Mental Health Services in Colorado: A Feasibility Study. Denver: Colorado Department of Institutions, 1992.
Daft RL:Organization Theory and Design. Cincinnati, OH: South-Western College Printing, 1997.
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.
Christianson J, Manning W, Lurie N, et al.: Utah's prepaid mental health plan: The first year.Health Affairs 1995; 14:160–172.
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.
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.
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.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Bloom, J.R., Devers, K., Wallace, N.T. et al. Implementing capitation of medicaid mental health services in Colorado: Is “readiness” a necessary condition?. The Journal of Behavioral Health Services & Research 27, 437–445 (2000). https://doi.org/10.1007/BF02287825
Issue Date:
DOI: https://doi.org/10.1007/BF02287825