Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #109452

Virginia L. Miller, DrPH, Zongshan Lai, MPH, R. Michael Massanari, MD, MS, and Leslie Mahlmeister, MBA. Center for Healthcare Effectiveness Research, Wayne State University School of Medicine, RM 121 Shiffman Medical Library, 4325 Brush Street, Detroit, MI 48201, 313.577.5189, mmassana@med.wayne.edu

In 2002, Michigan joined a growing number of states utilizing managed care models for the delivery of mental health services in order to reduce the cost of mental health care. While concern has been expressed that managed care may inappropriately reduce access to mental health services, the issue has received little systematic examination (Surgeon General's report, 1999). In Michigan, Medicaid managed care guidelines mandate eligibility screening every 30 days. Wayne State University Project CARE assessed the extent to which this policy interrupts continuity/access to care and/or poses a barrier. Our objectives included: to assess the magnitude of switching managed care plans among the patients served by a large community mental health agency; to describe the population of patients switching among the plans; to identify reasons for switching and its effect on continuity/access to care; and to propose policy recommendations to ensure optimal access/continuity of services. Data from the community mental health database for the period 10.01.02 through 3.31.03 were examined. During this initial period, more than 3800 patients, representing approximately 7 percent of the total patient population served through the community mental health agency, changed their managed care plan. During the subsequent time period 4.01.03 through 9.30.03, the proportion of patients switching managed care plans dropped to under 3 percent. These findings highlight the critical role of information technology and ongoing systematic measurement for assessing quality of services under managed care.

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