Premium
Two‐Year Outcomes of Fee‐for‐Service and Capitated Medicaid Programs for People with Severe Mental Illness
Author(s) -
Cuffel Brian J.,
R. Bloom Joan,
Wallace Neal,
Hu Tehwei
Publication year - 2002
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/1475-6773.026
Subject(s) - capitation , medicaid , mental illness , mental health , medicine , fee for service , family medicine , capitation fee , psychiatry , health care , finance , business , payment , economics , economic growth
Objective. To examine the effects of two models of capitation on the clinical outcomes of Medicaid beneficiaries in the state of Colorado. Data Source. A large sample of adult, Medicaid beneficiaries with severe mental illness drawn from regions where capitation contracts were (1) awarded to local community mental health agencies (direct capitation), (2) awarded to a joint venture between local community mental health agencies and a large, private managed behavioral health organization, and (3) not awarded and care continued to be reimbursed on a fee‐for‐service basis. Study Design. The three samples were compared on treatment outcomes assessed over 2 years (total n =591). Data Collection Methods. Study participants were interviewed by trained, clinical interviewers using a standardized protocol consisting of the GAF, BPRS, QOLI, and CAGE. Principal Findings. Outcomes were comparable across most outcome measures. When outcome differences were evident, they tended to favor the capitation samples. Conclusions. Medicaid capitation in Colorado does not appear to have negatively affected the outcomes of people with severe mental illness during the first 2 years of the program. Furthermore, the type of capitation model was unrelated to outcomes in this study.