Perspective: Competing Interests: Public-Sector Managed Behavioral Health Care
| Autor: | Laurie L. Burgess, Michael H. Bailit |
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| Rok vydání: | 1999 |
| Předmět: | |
| Zdroj: | Health Affairs. 18:112-115 |
| ISSN: | 1544-5208 0278-2715 |
| Popis: | The development of public-sector managed behavioral health care programs in the 1990s to serve Medicaid and other publicly financed populations represented a dramatic change in economic control and power within the behavioral health care system. Some have cogently argued that states make decisions regarding how to contract out (“carve out”) the management of such programs and which carve-out model to use based upon a complex consideration of strategic objectives within a political context. This paper argues that, on the contrary, it is changes in market power and political influence that drive states’ purchasing choices and subsequent decisions. A case in point, we observe, is the managed behavioral health care market. Providers that lost control and power in the first publicsector managed behavioral health care programs reacted aggressively. Their behavior, in turn, shaped the market that now offers program models in which providers play a dramatically different role from the one they assumed in the original carve-out models. State purchasers must be cognizant of this power shift, of how the market has influenced (and influences) their managed behavioral health care choices, and of what the implications are for a state that chooses to implement a carved-out managed behavioral health care program today. Development And Impact Of Carve-Outs |
| Databáze: | OpenAIRE |
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