title: What happens when capitated behavioral health comes to town? The transition from the Fort Bragg demonstration to a capitated managed behavioral health contract.
abstract: Capitated managed care contracts for behavioral health services are becoming more prevalent across the country in both public and private sectors. This study followed the transition from a demonstration project for child mental health services to a capitated managed behavioral health care contract with a for-profit managed care company. The focus of the study was on the impact--at both the service system and the individual consumer level--pertaining to the start-up and maintenance of a capitated managed behavioral health program. A case study using multiple methods and multiple sources of information incorporated a program fidelity framework that examined micro to macro levels of program implementation. The findings of this study include the following: access to services decreased, the lengths of stay and average daily census in the more intensive levels of treatment declined, difficult-to-treat children were shifted to the public sector, and ratings of service system performance and coordination fell.
authors.affiliation: Vanderbilt Institute of Public Policy Studies, Vanderbilt University, Nashville, TN 37203, USA. c.heflinger@vanderbilt.edu
authors.forename: C A
authors.initials: CA
authors.lastname: Heflinger
authors.forename: D A
authors.initials: DA
authors.lastname: Northrup
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000706:statistics & numerical data; D002204:Capitation Fee; D002648:Child; D003361:Cost Allocation / Q000706:statistics & numerical data; D006264:Health Benefit Plans, Employee; D006297:Health Services Accessibility / Q000592:standards / Q000706:statistics & numerical data*; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D008605:Mental Health Services / Q000191:economics / Q000458:organization & administration* / Q000592:standards / Q000706:statistics & numerical data; D009657:North Carolina; D011787:Quality of Health Care / Q000592:standards / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D014600:Utilization Review / Q000592:standards / Q000706:statistics & numerical data*