The 130th Annual Meeting of APHA

Abstract #41336

William R. Breakey, MD, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Meyer 4-181, Johns Hopkins Hospital, Baltimore, MA 21287-7481, (410) 955-2302, bbreakey@jhmi.edu, Pamela J. Fischer, PhD, Homeless Programs Branch, Center for Mental Health Services, Substance Abuse and Mental Health Services Administration, 5600 Fishers Lane, Room 11C-05, Rockville, MD 20857, and Donald M. Steinwachs, PhD, Department of Health Policy and Management, Johns Hopkins University, 624 North Broadway, Baltimore, MD 21205.

This paper describes an evaluation of mental health services provided under an experimental capitated payment arrangement. Under the terms of the capitation experiment, eligible patients with major mental illnesses and histories of high utilization of services received comprehensive mental health services from one of two competitively selected programs. The study employed a controlled design, with eligible patients randomly assigned either to the capitation group or to a control group who remained in the conventional fee-for-service system, with their care funded mainly by Medicaid. Subjects were interviewed at time of study entry and again 18-months later using a structured interview schedule to obtain data on health status, health service utilization, functional capacity and quality of life. Findings indicated that the patients in the capitated programs were less likely to be admitted for inpatient psychiatric treatment, made less use of emergency services and were more likely to get general medical and dental care. Overall clinical outcomes, functional outcomes and quality of life outcomes were very similar for capitation patients and control subjects, but several interesting differences emerged.

Learning Objectives:

• To understand the benefits to patients who have been treated in the capitation program.

Keywords: Mental Health Services, Financing

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Baltimore Mental Health Systems, Inc.
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: Grant to partially support this reserach