Mental health care quality under managed care in the United States: a view from the Health Employer Data and Information Set (HEDIS).
OBJECTIVE
This study examined the rates and correlates of mental health care performance measures in the Health Employer Data and Information Set (HEDIS).


METHODS
For all 384 health maintenance organizations (HMOs) participating in the HEDIS program of the National Committee for Quality Assurance during 1999, analyses examined the rates of compliance with five mental health care performance measures and their association with general medical care quality, public reporting, and HMO finances.


RESULTS
The mean rate of mental health care performance was 48.0%, compared with 69.2% for non-mental-health care domains. In multivariate models adjusted for plan characteristics, scores for worse quality of non-mental-health domains, failure to report data publicly, and low medical-loss ratio (proportion of revenues spent on clinical care) all predicted poor mental health care performance.


CONCLUSIONS
Better general medical care, transparency of reporting, and commitment of fiscal resources to clinical care predicted better mental health care performance for U.S. HMOs.
Druss
Benjamin G
BG
Department of Psychiatry, Yale University, New Haven, CT, USA. benjamin.druss@yale.edu
Miller
Carolyn L
CL
Rosenheck
Robert A
RA
Shih
Sarah C
SC
Bost
James E
JE
D006279:Health Maintenance Organizations / Q000191:economics / Q000592:standards; D006801:Humans; D016015:Logistic Models; D008329:Managed Care Programs / Q000191:economics / Q000592:standards*; D008605:Mental Health Services / Q000592:standards*; D011785:Quality Assurance, Health Care / Q000706:statistics & numerical data; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data; D011787:Quality of Health Care / Q000706:statistics & numerical data*; D014481:United States