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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 Case Management Services, Access and Mix, Age 4-17, by State Fiscal Years: 1994-2001
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f4-hcfr-26-1-023: Annual Predicted Probability of Case Management Services, Access and Mix, Age 4-17, by State Fiscal Years: 1994-2001

Mentions: We see the first positive effect of managed care on access in case management (Table 6). Youth in managed care had a 211-percent greater chance of using this service, an increase in probability of 0.05 (Figure 4). The effect is even larger when looking at those in treatment, where youth had 0.266 greater probability of using case management. In the Tennessee-only model, the effect is smaller than in the pooled results, but still large and positive. Figure 4 shows the large increase in the conditional probability of using this service (mix), and a less pronounced increase in access, 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 Case Management 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

f4-hcfr-26-1-023: Annual Predicted Probability of Case Management Services, Access and Mix, Age 4-17, by State Fiscal Years: 1994-2001
Mentions: We see the first positive effect of managed care on access in case management (Table 6). Youth in managed care had a 211-percent greater chance of using this service, an increase in probability of 0.05 (Figure 4). The effect is even larger when looking at those in treatment, where youth had 0.266 greater probability of using case management. In the Tennessee-only model, the effect is smaller than in the pooled results, but still large and positive. Figure 4 shows the large increase in the conditional probability of using this service (mix), and a less pronounced increase in access, 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