Serious mental illness and capitation financing

Traditional organization and financing of mental health care has not adequately served the needs of persons with serious mental illness. Capitation financing is being tested in several localities, but little experimental data has been yielded to date, and it is mixed. The results from the Rochester...

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Bibliographic Details
Published in:Behavioral sciences & the law 1994, Vol.12 (4), p.379-388
Main Author: Reed, Sylvia K.
Format: Article
Language:English
Subjects:
Capitation Fee
Cost Allocation
Health Services Needs and Demand
Health Services Research
Health technology assessment
Humans
Long-Term Care - economics
Managed Care Programs - economics
Managed Care Programs - organization & administration
Mental Disorders - economics
Mental Disorders - therapy
Organizational Culture
Pilot Projects
United States
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Summary:Traditional organization and financing of mental health care has not adequately served the needs of persons with serious mental illness. Capitation financing is being tested in several localities, but little experimental data has been yielded to date, and it is mixed. The results from the Rochester experiment were positive but limited, and some other pilots also reported positive experiences with capitation. Others have ended prematurely or confronted obstacles. Experimental findings are also anticipated from the Philadelphia and California pilots, and others are just beginning. Existing financing mechanisms, cost‐shifting efforts, and professional cultures represent powerful obstacles to successfully implementing capitation financing for care of persons with long‐term mental illnesses, and potential incentives to underserve enrollees require adequate accountability structures. In spite of obstacles, the goodness of fit between the needs of persons with serious mental illness and capitation flexibility warrant further exploration of this financing modality.
ISSN:0735-3936
1099-0798
DOI:10.1002/bsl.2370120407