Using information to guide managed behavioral health care.
This evaluation of substance abuse and mental health treatment services in Arizona discusses and illustrates the use of data already collected by the State to manage and monitor the public behavioral health sector. The authors utilize a framework that focuses on rate-setting and financial incentives; provider profiling and education; and monitoring of data quality and system-wide performance. Information and analysis can contribute to key management activities and forces that guide behavior in the system toward optimal system performance. Using data from 33,208 Medicaid-covered and uninsured adults, service mix varied substantially by region; for example, spending on residential care ranged from 0% to 40% for substance abuse treatment clients. By focusing on a smaller group of client with functional assessments, it also appears that regional spending levels varied considerably, for reasons not explained by client demographics or clinical measures. Finally, longitudinal data show that the regional managed care organizations are moving in different directions with regard to client mix and spending priorities. All of this variation suggests that there may be considerable latitude to guide and improve system-wide performance.
Tompkins
Christopher
C
Associate Professor, Schneider Institute for Health Policy, Heller Graduate School, Brandeis University, Waltham, MA 02454, USA. tompkins@brandeis.edu
Perloff
Jennifer
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D001130:Arizona; D001524:Behavioral Medicine / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000458:organization & administration* / Q000706:statistics & numerical data; D008484:Medicaid / Q000458:organization & administration* / Q000706:statistics & numerical data; D008605:Mental Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011787:Quality of Health Care; D011907:Rate Setting and Review; D013221:State Health Plans / Q000458:organization & administration*; D016320:Substance Abuse Treatment Centers / Q000458:organization & administration; D019966:Substance-Related Disorders / Q000534:rehabilitation; D014481:United States