title: The effects of behavioral health reform on safety-net institutions: a mixed-method assessment in a rural state.
abstract: In July 2005, New Mexico initiated a major reform of publicly-funded behavioral healthcare to reduce cost and bureaucracy. We used a mixed-method approach to examine how this reform impacted the workplaces and employees of service agencies that care for low-income adults in rural and urban areas. Information technology problems and cumbersome processes to enroll patients, procure authorizations, and submit claims led to payment delays that affected the financial status of the agencies, their ability to deliver care, and employee morale. Rural employees experienced lower levels of job satisfaction and organizational commitment and higher levels of turnover intentions under the reform when compared to their urban counterparts.
authors.affiliation: Pacific Institute for Research and Evaluation, Behavioral Health Research Center of the Southwest, 612 Encino Place NE, Albuquerque, NM, 87102, USA, cwillging@pire.org.
authors.forename: Cathleen E
authors.initials: CE
authors.lastname: Willging
authors.forename: David H
authors.initials: DH
authors.lastname: Sommerfeld
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Aarons
authors.forename: Howard
authors.initials: H
authors.lastname: Waitzkin
mesh_terms: D018166:Health Care Reform; D006282:Health Personnel; D006291:Health Policy; D006801:Humans; D007588:Job Satisfaction; D008490:Medical Informatics; D008605:Mental Health Services / Q000191:economics / Q000458:organization & administration*; D009516:New Mexico; D012051:Reimbursement Mechanisms; D012424:Rural Population; D064876:Safety-net Providers / Q000191:economics / Q000458:organization & administration*