Outcome assessment of the medicaid managed care program in Harris County (Houston)

Nowadays, managed care has taken over the management of the Medicaid program in most states of the nation. The patients treated in the public sector managed care system are very vulnerable and at high risk. Thus, we decided to measure the impact of managed care in the public-sector population of Tex...

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Bibliographic Details
Published in:Psychiatric quarterly 2003, Vol.74 (2), p.103-114
Main Authors: AVERILL, Patricia M, RUIZ, Pedro, SMALL, David R, GUYNN, Robert W, TCHEREMISSINE, Oleg
Format: Article
Language:English
Subjects:
Adult
Biological and medical sciences
Catchment Area (Health)
Drug abuse
Female
Health care access
Humans
Length of Stay
Male
Managed Care Programs - statistics & numerical data
Medicaid
Medicaid - statistics & numerical data
Medical sciences
Medicare
Mental Disorders - epidemiology
Mental Disorders - rehabilitation
Mental Disorders - therapy
Mental health
Mental health care
Mental Health Services - standards
Mental Health Services - statistics & numerical data
Organization of mental health. Health systems
Outcome Assessment (Health Care)
Patient Admission - statistics & numerical data
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Public sector
Retrospective Studies
Social psychiatry. Ethnopsychiatry
Substance abuse treatment
Texas - epidemiology
Vulnerable Populations
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Summary:Nowadays, managed care has taken over the management of the Medicaid program in most states of the nation. The patients treated in the public sector managed care system are very vulnerable and at high risk. Thus, we decided to measure the impact of managed care in the public-sector population of Texas. To this end, we assessed the treatment outcome at the Harris County Psychiatric Center (HCPC). Our results showed that after the implementation of the Medicaid managed care program in Houston, the bed utilization at HCPC decreased by 32% and the readmission rate increased by 21%; concomitantly, the length of stay decreased from 15.6 days to 9.3 days. Additionally, African-American and Hispanic-American patients were more negatively affected than Caucasian patients. Undoubtedly, the implementation of the Medicaid managed care system in Texas has led to untoward effects in the quality of care provided to the most disadvantaged population of the state.
ISSN:0033-2720
1573-6709
DOI:10.1023/A:1021389509367