A multi-site study of Medicaid-funded managed care versus fee-for-service plans' effects on mental health service utilization of children with severe emotional disturbance

• Published in: The journal of behavioral health services & research Vol. 31; no. 4; pp. 384 - 402
• Main Authors: Cook, Judith A, Heflinger, Craig Anne, Hoven, Christina W, Kelleher, Kelly J, Mulkern, Virginia, Paulson, Robert I, Stein-Seroussi, Al, Fitzgibbon, Genevieve, Burke-Miller, Jane, Williams, Melissa, Kim, Jong-Bae
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 01.10.2004
• Subjects: Adult; Affective Symptoms - therapy; Child; Children & youth; Fee-for-Service Plans - economics; Fee-for-Service Plans - statistics & numerical data; Female; Health services; Humans; Logistic Models; Low income groups; Male; Managed care; Managed Care Programs - economics; Managed Care Programs - statistics & numerical data; Medicaid; Medicaid - economics; Medicaid - statistics & numerical data; Mental health; Mental health care; Mental Health Services - statistics & numerical data; Multivariate analysis; Stress, Psychological; Studies; Substance abuse treatment; Surveys and Questionnaires; United States; United States; United States > US
• ISSN: 1094-3412; 1556-3308
• DOI: 10.1007/BF02287691

Although Medicaid-funded managed care arrangements are commonly used in the delivery of mental health and substance abuse services to low-income children and youth, little is known about the effectiveness of such efforts. This article examines differences in mental health services utilization between children and youth with severe emotional disturbance covered by Medicaid-funded managed care behavioral health plans and those covered by fee-for-service plans. Data are from a federally funded multi-site study. In multivariate analyses controlling for child and caregiver demographic and clinical factors, enrollment in a managed care behavioral health plan was associated with lower inpatient/residential, psychiatric medication, and nontraditional services utilization. No difference was found in outpatient services utilization. Medicaid-funded managed care behavioral health plans appear to reduce use of some types of mental health services, but it is important to address the question of whether low-income children's enrollment in such programs deprives them of needed services.