AHCA Highlights Policy Brief 1: Using Research to Shape Future Directions of Children’s Managed Mental Health Care
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FMHI Publication ID:
AHCA series, 220-PB1
managed care, child mental health, financing
Through a contractual arrangement with the Florida Agency for Health Care Administration (AHCA), the Louis de la Parte Florida Mental Health Institute (FMHI) has conducted studies of Florida’s implementation of managed mental health care over the past 11 years (1996-2006).
Prepaid mental health plans (PMHPs) and health maintenance organizations (HMOs) are the two forms of managed care arrangements primarily used in Florida for the provision of mental health services. PMHPs represent a mental health care ‘carve out’ plan in which a managed care organization (MCO) provides or arranges for a range of mental health services for plan participants. Participants receive their physical health benefits provided through fee-for service (FFS) from Medipass. In this arrangement, the PMHP managing entity is paid by AHCA through a risk-adjusted, fixed monthly fee per enrollee.
The studies reviewed utilized a variety of methods. Yearly studies on the implementation of the PMHPs focused in one Area involved the use of comparison site(s) (an Area, or Areas, that had yet to implement the PMHP) while other yearly implementation studies compared plans within an Area or Areas where managed care had been implemented. Methodology across studies was mixed and included administrative data analyses (Medicaid eligibility and claims data), mail surveys, caregiver and provider interviews, focus groups and file reviews.
The content areas from the 20 studies published between 1998-2006 and included in the review are broadly represented by the following areas:
Quality of Care
- Consumer Engagement
- Appropriateness of Services
- Child Outcomes
- Differences Across Managed Care Arrangements (HMO vs. PMHP)
- Service Penetration Rates/Service Use
- Ethnic and Racial Disparities
- Mental Health Literacy
Summative findings, trends, and policy and practice recommendations from the studies regarding children’s managed mental health care are presented.
Fixsen, A., & Armstrong, M.I. (2007). AHCA highlights policy brief 1: Using research to shape future directions of children’s managed mental health care. (AHCA series, 220-PB1). Tampa, FL: University of South Florida, Louis de la Parte Florida Mental Health Institute.