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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
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, 301-443-4569, pfischer@samhsa.gov and William R. Breakey, MD, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Meyer 4-181, Johns Hopkins Hospital, Baltimore, MA 21287-7481.
The observational component of the study was designed to gather descriptive information about the day-to-day operations of the programs to ascertain how the services offered under the capitated funding arrangement differed from those provided by the traditional fee-for-service reimbursement programs. Of particular importance was to document whether capitation spurred programmatic innovations, defined as alterations to the conventional service delivery pattern. The two main qualitative methods used were (1) participant observation and (2) structured open-ended interviews. A number of findings supporting the effectiveness of providing capitated services for a high use population of clients emerged from the observational study. The capitation program affected clinical practice by broadening conventional definitions of treatment and modes of delivery. Capitation allowed a great deal of flexibility in establishing individualized treatment programs for clients. Provider roles in the capitation programs differed from fee-for-service programs in being more reliant on a team approach to treatment, offering a wider array of services to meet the expressed needs of the individual client, and providing services in extra-clinical settings. Providers expressed feeling a high level of satisfaction with the amount of autonomy they have in determining treatment plans as well as gratification at the improvements they have achieved in their clients' quality of life.
Learning Objectives:
Keywords: Mental Health,
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.