Community mental health in the nineties: Public sector managed care


When this report was being written (1993), the country was embroiled in the challenging task of revamping the American heal th care system. The Clinton administration was leaning toward a system based on '~managed competition", in which both public and private-sector payors may be negotiating for services with organized health-care delivery systems competing at the local community level. At the same time, public sector mental health systems are beginning to make radical changes as well. According to Charles Ray, Executive Director of the National Council of Community Mental Health Centers, "traditional public payors are quickly reaching the conclusion that some combination of public or private managed care is the only recourse to avoid massive deficits, with the key focus at the state level being Medicaid". During 1992 Massachusetts took the lead. In signing a contract with Mental Heal th Management of America (a private, for-profit, managed care firm) to manage the state's mental health and substance abuse Medicaid benefit on a capitated, shared risk basis, Massachusetts became the first state to set up a comprehensive privatized public sector managed care program. In a similar vein, Oregon has developed a proposal for funding health and mental health services according to defined diagnostic categories prioritized for Medicaid spending. Minnesota also has developed a managed care public/private system, but it leaves

DOI: 10.1007/BF02207485


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@article{Minkoff1994CommunityMH, title={Community mental health in the nineties: Public sector managed care}, author={Kenneth Minkoff}, journal={Community Mental Health Journal}, year={1994}, volume={30}, pages={317-321} }