State Mental Health Service Funding

Public mental health services are shaped by multiple sources of funding. The two primary sources of funding are Medicaid and state general fund dollars, which on average fund 90 percent of the system. However, 10 percent of the system is funded by Medicare, federal mental health services block grant funds and county as well as municipal funds. For youth facing serious mental health conditions, funding for services may also be provided by other sources, including schools and the State Children’s Health Insurance Program (S-CHIP). (To read more click on the link below)

What Is Managed Care? 

Managed care is an approach to financing and delivering health care that seeks to control costs and ensure or improve quality of care through a variety of methods, including provider network management, utilization management and quality assurance.  Historically, Medicaid services for disabled beneficiaries, including mental health services, have been provided on a fee-for-service basis where providers are paid for each billable service provided. In contrast, managed care Medicaid programs pay for some or all services at a prepaid rate, often based on enrollment. (To read more click on the link below)

What to Ask: A Checklist for Advocates

Managed care is an approach to financing and delivering health care that attempts to control costs and ensure or improve quality of care. Increasingly, states are looking to managed care as a strategy to contain the cost of mental health care in Medicaid programs. Managed care ranges from Primary Care Case Management (PCCM) models that provide payments for case management and care coordination services, while financing most other services on a fee-for-service (FFS) basis, to full-risk capitated models.  This checklist is intended as a first step to help advocates ask the right questions and request pertinent information, particularly for full or partial-risk managed care plans.  (To read more click on the link below)

Observations/ Recommendations  Managed Care and Community Mental Health Systems of Care

For decades, the philosophy of community-based systems of care has guided the delivery of mental health services for individuals served by publicly funded agencies.  This philosophy supports system attributes that include a broad array of services; interagency collaboration; treatment in the least-restrictive setting; individualized services; family and consumer involvement; and services responsive to the needs of diverse ethnic and racial populations. The notion of systems of care emerged in an era when managed health care also was gaining popularity. However, the effect of managed care on the delivery of community mental health and substance-abuse services—also known as behavioral health services—has not been widely studied.  (To read more click on the link below)

Managed Care Documents

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