MARK SCHLESINGER is research coordinator at the John F. Kennedy School of Government, Center for Health Policy and Management.
Competitive bidding and states' purchase of services: The case of mental health care in Massachusetts
Article first published online: 1 FEB 2007
Copyright © 1986 Association for Public Policy Analysis and Management
Journal of Policy Analysis and Management
Volume 5, Issue 2, pages 245–263, 1986
How to Cite
Schlesinger, M., Dorwart, R. A. and Pulice, R. T. (1986), Competitive bidding and states' purchase of services: The case of mental health care in Massachusetts. J. Pol. Anal. Manage., 5: 245–263. doi: 10.1002/pam.4050050205
- Issue published online: 1 FEB 2007
- Article first published online: 1 FEB 2007
- Cited By
Over the past two decades states have significantly increased their use of competitive bidding to purchase health and social services from private agencies. Competitive contracting is thought to facilitate program administration, to reduce costs, and to increase the quality of delivered services. We evaluate these claims in light of Massachusetts' experience with competitive contracting for mental health care. We find that few of the expected benefits are achieved. In practice, supposedly competitive bidding systems often degenerate into administratively complicated negotiations between the state and private monopolies. This results in higher costs and lower quality of services. In light of this negative assessment, three strategies for reform are proposed and evaluate.