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Impact of Managed Care on Mental Health Services for Children and Their Families

NCJ Number
174366
Journal
Future of Children Volume: 8 Issue: 2 Dated: Summer/Fall 1998 Pages: 119-133
Author(s)
B A Stroul; S A Pires; M I Armstrong; J C Meyers
Date Published
1998
Length
15 pages
Annotation
Preliminary results from the nationwide Health Care Reform Tracking Project (HCRTP) inform discussions about the impact of managed behavioral health care on services for children and adolescents enrolled in State Medicaid programs.
Abstract
Most States have used some type of "carve-out design" to finance the delivery of behavioral health services, and there is a trend toward contracting with private-sector, for-profit companies to administer these benefits. Generally, managed care has resulted in greater access to basic behavioral health and community-based services for children and adolescents, although access to inpatient hospital care has been reduced. Under managed care, it also has been more difficult for youths with serious emotional disorders, as well as the uninsured, to obtain needed services. Along with managed care has come a trend toward briefer, more problem-oriented treatment approaches for behavioral health disorders. A number of problems related to the implementation of managed behavioral health care for children and adolescents were illuminated by the HCRTP. First, there is concern that ongoing efforts to develop systems of care for youths with serious emotional disorders are not being linked with managed care initiatives. The lack of investment in service- capacity development, the lack of coordination with other agencies that serve children with behavioral health problems, and cumbersome preauthorization requirements that may restrict access to appropriate service delivery were other concerns raised by respondents about managed care. Based on stakeholder interviews, the recommendations of this paper pertain to system planning, stakeholder involvement, access and service delivery, data and evaluation, and advocacy and oversight. 25 references