Key Personnel:
David L. Shern, Ph.D.
Patricia Robinson, M.S.W.
Evaluation of the prepaid mental health program
Publication Date: 4/1/1999
Description:
In this report we summarize the results and recommendations from the second year of our evaluation of the Florida Managed Mental Health Care Initiative. Under a 1915(b) Medicaid waiver, the Agency for Health Care Administration (AHCA) established two differing approaches to managing mental health care in the Tampa Bay Area (AHCA Area 6). We conducted a multi-method evaluation that assessed the degree to which these differing approaches have affected access, cost, quality and outcomes of care.
We contrasted two financing conditions in the demonstration area and one in a comparison area, AHCA Area 4 (Jacksonville and Daytona Beach), that continues to use a largely unmanaged, fee for service system for financing mental health services. In the first managed care condition (the Prepaid Mental Health Program, PMHP) a specialty mental health organization manages a comprehensive mental health benefit for its enrollees. The benefit is financed through a pre-paid, risk adjusted premium. Health and pharmacy benefits for PMHP enrollees continue to be reimbursed on a fee for service basis. The second financing condition consists of HMOs that receive an integrated, risk adjusted premium to provide the full range of health and mental health services to their enrollees. HMOs also are at risk for pharmacy benefits.
