title: Managed behavioral health care: an instrument to characterize critical elements of public sector programs.
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.
  
  
  METHODS
  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.
  
  
  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.
  
  
  RESULTS
  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.
authors.affiliation: RAND Health, Santa Monica, CA 90407-2138, USA.
authors.forename: M Susan
authors.initials: MS
authors.lastname: Ridgely
authors.forename: Julienne
authors.initials: J
authors.lastname: Giard
authors.forename: David
authors.initials: D
authors.lastname: Shern
authors.forename: Virginia
authors.initials: V
authors.lastname: Mulkern
authors.forename: M Audrey
authors.initials: MA
authors.lastname: Burnam
mesh_terms: D001524:Behavioral Medicine / Q000458:organization & administration; D003625:Data Collection; D018588:Fee-for-Service Plans / Q000191:economics* / Q000458:organization & administration / Q000592:standards; D006296:Health Services / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000145:classification; D006302:Health Services Research / Q000379:methods*; D006801:Humans; D008329:Managed Care Programs / Q000191:economics* / Q000458:organization & administration / Q000592:standards; D008484:Medicaid / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D008605:Mental Health Services / Q000191:economics / Q000458:organization & administration* / Q000592:standards; D011635:Public Health Administration; D014481:United States