Managed Mental Health Care: Cost Considerations for Community Health Centers

摘要

Community Health Centers (CHC) are increasingly participating in prepaid financing arrangements for the delivery of primary health care services. Such activity is being encouraged by payment sources, both public and private, which seek more comprehensive benefits, along with the primary care services already provided by CHCs. To provide information for CHCs considering whether to enter this specialty service arena, UNISON surveyed four insurance plans offering mental health and chemical dependency benefits and a state Medicaid agency. The insurance plans included a commercial HMO, a Medicaid HMO and two indemnity insurance plans. The purpose of the interviews was to discover the utilization and cost parameters of providing these services on a prefunded, as opposed to fee-for-service, basis. Of particular concern were the methods of managing and controlling cost and utilization. The report consists of the Survey Report which deals with the methods of managing and controlling cost and utilization, a Executive Summary, which reports aggregate data, supplemented with contextual information, and an Annotated Bibliography.