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Effects of managed care on southern youths' behavioral services use.

Saunders RC, Heflinger CA - Health Care Financ Rev (2004)

Bottom Line: Managed care reduced access to behavioral care overall, overnight services (e.g., inpatient), and specialty outpatient services.However, managed care had pronounced effects on use of case management services.We also document differences in access and mix of behavioral services used over time by race, sex, age, and Medicaid enrollment category.

View Article: PubMed Central - PubMed

Affiliation: Vanderbilt University, Nashville, TN 37203, USA. robert.c.saunders@vanderbilt.edu

ABSTRACT
Children and adolescents' access to Medicaid-financed behavioral health services was examined over 8 years in Tennessee (managed care) and Mississippi (fee-for-service [FFS]) using logistic regression. Managed care reduced access to behavioral care overall, overnight services (e.g., inpatient), and specialty outpatient services. Managed care also restricted the relative use of overnight and specialty outpatient for children and adolescents. However, managed care had pronounced effects on use of case management services. We also document differences in access and mix of behavioral services used over time by race, sex, age, and Medicaid enrollment category.

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Annual Predicted Probability of Specialty Outpatient Services, Access and Mix, Age 4-17, by State Fiscal Years: 1994-2001
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f3-hcfr-26-1-023: Annual Predicted Probability of Specialty Outpatient Services, Access and Mix, Age 4-17, by State Fiscal Years: 1994-2001

Mentions: The odds of a child within the Medicaid population using specialty outpatient care are 15 percent less under managed care (Table 5). This corresponds to a reduction in the probability of using specialty outpatient services of 0.008 (Figure 3). Even among youth in treatment, youth in managed care have a reduced likelihood of using these services with an odds ratio of 0.915. In probability terms, this translates to a reduction of 0.022. Within Tennessee, we see a statistically insignificant decrease in access, but significant reduction in the mix of specialty outpatient among youth in treatment. Figure 3 shows the slight dip in both access and mix of this service coinciding with the behavioral health carve-out beginning in FY 1997.


Effects of managed care on southern youths' behavioral services use.

Saunders RC, Heflinger CA - Health Care Financ Rev (2004)

Annual Predicted Probability of Specialty Outpatient Services, Access and Mix, Age 4-17, by State Fiscal Years: 1994-2001
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4194876&req=5

f3-hcfr-26-1-023: Annual Predicted Probability of Specialty Outpatient Services, Access and Mix, Age 4-17, by State Fiscal Years: 1994-2001
Mentions: The odds of a child within the Medicaid population using specialty outpatient care are 15 percent less under managed care (Table 5). This corresponds to a reduction in the probability of using specialty outpatient services of 0.008 (Figure 3). Even among youth in treatment, youth in managed care have a reduced likelihood of using these services with an odds ratio of 0.915. In probability terms, this translates to a reduction of 0.022. Within Tennessee, we see a statistically insignificant decrease in access, but significant reduction in the mix of specialty outpatient among youth in treatment. Figure 3 shows the slight dip in both access and mix of this service coinciding with the behavioral health carve-out beginning in FY 1997.

Bottom Line: Managed care reduced access to behavioral care overall, overnight services (e.g., inpatient), and specialty outpatient services.However, managed care had pronounced effects on use of case management services.We also document differences in access and mix of behavioral services used over time by race, sex, age, and Medicaid enrollment category.

View Article: PubMed Central - PubMed

Affiliation: Vanderbilt University, Nashville, TN 37203, USA. robert.c.saunders@vanderbilt.edu

ABSTRACT
Children and adolescents' access to Medicaid-financed behavioral health services was examined over 8 years in Tennessee (managed care) and Mississippi (fee-for-service [FFS]) using logistic regression. Managed care reduced access to behavioral care overall, overnight services (e.g., inpatient), and specialty outpatient services. Managed care also restricted the relative use of overnight and specialty outpatient for children and adolescents. However, managed care had pronounced effects on use of case management services. We also document differences in access and mix of behavioral services used over time by race, sex, age, and Medicaid enrollment category.

Show MeSH
Related in: MedlinePlus