title: Assessment, authorization and access to medicaid managed mental health care.
abstract: Examined were effects on access of managed care assessment and authorization processes in California's 57 county mental health plans. Primary data on managed care implementation were collected from surveys of county plan administrators; secondary data were from Medicaid claims and enrollment files. Using multivariate fixed effects regression, we found that following implementation of managed care, greater access occurred in county plans where assessments and treatment were performed by the same clinician, and where service authorizations were made more rapidly. Lower access occurred in county plans where treating clinicians authorized services themselves. Results confirm the significant effects of managed care processes on outcomes and highlight the importance of system capacity.
authors.affiliation: Department of Psychology, Center for Mental Health Services Research, Institute of Personality and Social Research, University of California, 2140 Shattuck Ave, #409, Berkeley, CA 94720-1414, USA. mmasland@berkeley.edu
authors.forename: Mary C
authors.initials: MC
authors.lastname: Masland
authors.forename: Lonnie R
authors.initials: LR
authors.lastname: Snowden
authors.forename: Neal T
authors.initials: NT
authors.lastname: Wallace
mesh_terms: D002140:California; D004608:Eligibility Determination / Q000458:organization & administration*; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008329:Managed Care Programs / Q000458:organization & administration*; D008484:Medicaid / Q000458:organization & administration*; D008605:Mental Health Services