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Medicaid behavioral health carve-outs: a new generation of privatization decisions.
Harv Rev Psychiatry. 2000 Nov; 8(5):231-41.HR

Abstract

This article addresses issues related to the privatization of various functions within the mental health system. It acknowledges the contributions of Robert Dorwart, who explored trends with regard to the privatization of inpatient psychiatric services. The authors then highlight changes in the division of labor between the public and private sectors regarding the financing and delivery of mental health services and the management of the system. Responsibility for funding the mental health system has remained largely a public responsibility while responsibility for production or delivery of services in the mental health system is typically held by private, for-profit, and not-for-profit organizations. The roles of managing the mental health system and setting policy are now shared between the private and public sectors in a number of states that have implemented Medicaid behavioral health carve-out programs. This article explores the impact of such privatization on cost, access, and quality of services by examining the experiences of three states with carve-outs. The authors suggest that while organizational form is an important issue, concerns about privatization should be tempered by attention to the contracting decisions made by purchasers, the level of resources devoted to services, and the adequacy of administration of the system.

Authors+Show Affiliations

Department of Health Care Policy, Harvard Medical School, Boston, MA 02115, USA.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Review

Language

eng

PubMed ID

11118232

Citation

Donohue, J M., and R G. Frank. "Medicaid Behavioral Health Carve-outs: a New Generation of Privatization Decisions." Harvard Review of Psychiatry, vol. 8, no. 5, 2000, pp. 231-41.
Donohue JM, Frank RG. Medicaid behavioral health carve-outs: a new generation of privatization decisions. Harv Rev Psychiatry. 2000;8(5):231-41.
Donohue, J. M., & Frank, R. G. (2000). Medicaid behavioral health carve-outs: a new generation of privatization decisions. Harvard Review of Psychiatry, 8(5), 231-41.
Donohue JM, Frank RG. Medicaid Behavioral Health Carve-outs: a New Generation of Privatization Decisions. Harv Rev Psychiatry. 2000;8(5):231-41. PubMed PMID: 11118232.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Medicaid behavioral health carve-outs: a new generation of privatization decisions. AU - Donohue,J M, AU - Frank,R G, PY - 2000/12/16/pubmed PY - 2001/2/28/medline PY - 2000/12/16/entrez SP - 231 EP - 41 JF - Harvard review of psychiatry JO - Harv Rev Psychiatry VL - 8 IS - 5 N2 - This article addresses issues related to the privatization of various functions within the mental health system. It acknowledges the contributions of Robert Dorwart, who explored trends with regard to the privatization of inpatient psychiatric services. The authors then highlight changes in the division of labor between the public and private sectors regarding the financing and delivery of mental health services and the management of the system. Responsibility for funding the mental health system has remained largely a public responsibility while responsibility for production or delivery of services in the mental health system is typically held by private, for-profit, and not-for-profit organizations. The roles of managing the mental health system and setting policy are now shared between the private and public sectors in a number of states that have implemented Medicaid behavioral health carve-out programs. This article explores the impact of such privatization on cost, access, and quality of services by examining the experiences of three states with carve-outs. The authors suggest that while organizational form is an important issue, concerns about privatization should be tempered by attention to the contracting decisions made by purchasers, the level of resources devoted to services, and the adequacy of administration of the system. SN - 1067-3229 UR - https://www.unboundmedicine.com/medline/citation/11118232/Medicaid_behavioral_health_carve_outs:_a_new_generation_of_privatization_decisions_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=11118232.ui DB - PRIME DP - Unbound Medicine ER -