Medicaid managed care and the distribution of societal costs for persons with severe mental illness

The American Journal of Psychiatry
David L ShernRoger A Boothroyd

Abstract

Managed care financing strategies that involve financial risk to insurers can reduce budgeted health expenditures. However, resource substitution may occur and negate apparent savings in budgeted expenditures. These substitutions may be important for individuals with disabling illnesses. The distribution of societal costs for adults with mental illnesses enrolled in plans that differ in their financial risk is examined to evaluate the degree to which risk-based financing strategies result in net savings or in the differential distribution of costs across public or private payers. Six hundred twenty-eight adults with severe mental illnesses enrolled in three Medicaid plans that differ in financial risk arrangements were followed for 1 year to determine the distribution of resource use across Medicaid and other payers. Self-reported service use was obtained through interviews. Cost data were derived from self-reported expenditure, administrative, or agency data. Statistical procedures were used to control for preexisting group differences. Managed care was associated with a tendency toward reduced overall costs to Medicaid. However, private expenditures for managed care enrollees offset decreased Medicaid expenditures, resulting ...Continue Reading

Citations

Jan 27, 2009·Medical Care·Alisa B BuschRichard G Frank
Nov 15, 2014·BMC Health Services Research·Mary E CharlsonWalid Michelen
Aug 25, 2015·The Psychiatric Clinics of North America·Roderick ShanerJerome V Vaccaro

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