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Serious mental illness and capitation financing
Author(s) -
Reed Sylvia K.
Publication year - 1994
Publication title -
behavioral sciences and the law
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.649
H-Index - 74
eISSN - 1099-0798
pISSN - 0735-3936
DOI - 10.1002/bsl.2370120407
Subject(s) - capitation , flexibility (engineering) , finance , mental health , mental illness , medicine , incentive , accountability , psychiatry , business , payment , economics , political science , management , law , microeconomics
Abstract Traditional organization and financing of mental health care has not adequately served the needs of persons with serious mental illness. Capitation financing is being tested in several localities, but little experimental data has been yielded to date, and it is mixed. The results from the Rochester experiment were positive but limited, and some other pilots also reported positive experiences with capitation. Others have ended prematurely or confronted obstacles. Experimental findings are also anticipated from the Philadelphia and California pilots, and others are just beginning. Existing financing mechanisms, cost‐shifting efforts, and professional cultures represent powerful obstacles to successfully implementing capitation financing for care of persons with long‐term mental illnesses, and potential incentives to underserve enrollees require adequate accountability structures. In spite of obstacles, the goodness of fit between the needs of persons with serious mental illness and capitation flexibility warrant further exploration of this financing modality.