Managed behavioral health care

An instrument to characterize critical elements of public sector programs

M. Susan Ridgely, Julienne Giard, David Shern, Virginia Mulkern, M. Audrey Burnam

Research output: Contribution to journalArticle

Abstract

Objective. To develop an instrument to characterize public sector managed behavioral health care arrangements to capture key differences between managed and "unmanaged" care and among managed care arrangements. Study Design. The instrument was developed by a multi-institutional group of collaborators with participation of an expert panel. Included are six domains predicted to have an impact on access, service utilization, costs, and quality. The domains are: characteristics of the managed care plan, enrolled population, benefit design, payment and risk arrangements, composition of provider networks, and accountability. Data are collected at three levels: managed care organization, subcontractor, and network of service providers. Data Collection Methods. Data are collected through contract abstraction and key informant interviews. A multilevel coding scheme is used to organize the data into a matrix along key domains, which is then reviewed and verified by the key informants. Principal Findings. This instrument can usefully differentiate between and among Medicaid fee-for-service programs and Medicaid managed care plans along key domains of interest. Beyond documenting basic features of the plans and providing contextual information, these data will support the refinement and testing of hypotheses about the impact of public sector managed care on access, quality, costs, and outcomes of care. Conclusions. If managed behavioral health care research is to advance beyond simple case study comparisons, a well-conceptualized set of instruments is necessary.

Original languageEnglish (US)
Pages (from-to)1105-1123
Number of pages19
JournalHealth Services Research
Volume37
Issue number4
DOIs
StatePublished - Aug 2002
Externally publishedYes

Fingerprint

Public Sector
Managed Care Programs
managed care
public sector
health care
Delivery of Health Care
Medicaid
subcontractor
data collection method
Behavioral Research
Costs and Cost Analysis
Fee-for-Service Plans
costs
abstraction
fee
Health Services Research
Social Responsibility
service provider
Contracts
coding

Keywords

  • Managed behavioral health care
  • Managed care contracts
  • Medicaid managed care
  • Public sector

ASJC Scopus subject areas

  • Nursing(all)
  • Health(social science)
  • Health Professions(all)
  • Health Policy

Cite this

Managed behavioral health care : An instrument to characterize critical elements of public sector programs. / Ridgely, M. Susan; Giard, Julienne; Shern, David; Mulkern, Virginia; Burnam, M. Audrey.

In: Health Services Research, Vol. 37, No. 4, 08.2002, p. 1105-1123.

Research output: Contribution to journalArticle

Ridgely, M. Susan ; Giard, Julienne ; Shern, David ; Mulkern, Virginia ; Burnam, M. Audrey. / Managed behavioral health care : An instrument to characterize critical elements of public sector programs. In: Health Services Research. 2002 ; Vol. 37, No. 4. pp. 1105-1123.
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