Partial capitation versus fee-for-service in mental health care.
Reimbursement strategies represent a key tool in implementing public policy. Often the relationship between changes in reimbursement policy and changes in provider behavior is difficult to predict, particularly in complex service systems. Here we present findings from a multiyear study involving the comparison of alternative Medicaid reimbursement systems for intensive case management services: a fee-for-service arrangement developed specifically for this study, and the partial capitation system in use in New York State. We focus on the impact of these two reimbursement schemes on the number and types of services provided by case managers and on client outcomes.
D000293:Adolescent; D000328:Adult; D002204:Capitation Fee; D017046:Cost Savings; D018588:Fee-for-Service Plans; D006801:Humans; D008329:Managed Care Programs / Q000191:economics*; D008484:Medicaid / Q000191:economics; D001523:Mental Disorders / Q000191:economics* / Q000534:rehabilitation; D008605:Mental Health Services / Q000191:economics*; D008875:Middle Aged; D009518:New York; D010043:Outcome and Process Assessment, Health Care; D012051:Reimbursement Mechanisms / Q000191:economics; D013221:State Health Plans / Q000191:economics; D014481:United States