Capitation From a Provider's Perspective

Reed, Sylvia K.; Hennessy, Kevin D.; Brown, Suzanne W.; Fray, Jennifer

doi:10.1176/ps.43.12.1173

Cited by 6 publications

(1 citation statement)

References 3 publications

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“…(21,22) Initiated in 1987, this demonstration project included a coordinating corporation, capitated payments through a state office of mental hygiene, and COmnlunity mental health centers.…”

Section: Constructing a Plan For The Care Of The Chronically Mentatj~mentioning

confidence: 99%

Acute and chronic psychiatric care: Establishing boundaries

Sederer

Dickey

1995

Psych Quart

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Despite advances in psychiatry, a proportion of those with mental illness have episodes of severe illness, and a few of these patients may attain only partial recovery. In this respect, mental illness is similar to physical illness and systems of acute and chronic care are essential. As mental health care financing and delivery systems undergo further flux and reform, we will require clear, consensually developed definitions of levels of care, especially because of the complexities created by a legacy of a 2-tiered, public and private mental health system. This paper first will offer definitions and examples of acute and chronic illness and care. We will also address certain problems inherent to such a classification. We will then consider principles of and potential plans for a system of financing and care for the chronically mentally ill. Two existing plans will be reviewed as illustrations of innovations in chronic care. As health reform changes the financing and delivery of care for the mentally ill, an opportunity exists to integrate public and private monies and services and to improve upon the care of the acutely and chronically mentally ill.

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Section: Constructing a Plan For The Care Of The Chronically Mentatj~mentioning

confidence: 99%

Acute and chronic psychiatric care: Establishing boundaries

Sederer

Dickey

1995

Psych Quart

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Health maintenance organizations and persons with severe mental illness

McFarland

1994

Community Ment Health J

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Many if not most scenarios for reform of the U.S. health care system imply that health maintenance organizations (HMOs) will continue their rapid growth. Some advocates argue that a comprehensive health care system should offer services to the severely mentally ill on the same basis as the physically ill. Others note that severe mental illness has traditionally been addressed by a separate, social service system which, for all its deficiencies, has at least provided some level of care. Still others contend that allowing severely mentally ill persons "barrier free" access to health care would be prohibitively expensive. Inspired by this debate the author reviews our knowledge about HMOs and persons with severe mental illness. It is argued that workers in community mental health programs need to understand HMOs and their potential contribution to providing services for persons with severe mental illness.

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Roth

Snapp

Lauber

et al. 1998

Administration and Policy in Mental Health

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Risk-adjusted capitation rates based on a group's expected cost to a provider have been proposed to create incentives for including people with severe mental disabilities in managed healthcare systems. The most appropriate methods for classifying people according to levels of risk, however, have yet to be determined. This research employed cluster analysis statistical techniques to identify patterns of services delivered to a sample of 4,346 consumers in Ohio. Findings about the extent of client movement in and out of service clusters over time suggest caution in the implementation of risk-adjusted capitation plans, particularly those based primarily on past service utilization.

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Capitation From a Provider's Perspective

Cited by 6 publications

References 3 publications

Acute and chronic psychiatric care: Establishing boundaries

Acute and chronic psychiatric care: Establishing boundaries

Health maintenance organizations and persons with severe mental illness

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