Two-Year Outcomes of Fee-for-Service and Capitated Medicaid Programs for People with Severe Mental Illness
Article first published online: 3 SEP 2009
Health Services Research
Volume 37, Issue 2, pages 341–359, April 2002
How to Cite
Cuffel, B. J., R. Bloom, J., Wallace, N., Jaclyn W. Hausman and Hu, T.-w. (2002), Two-Year Outcomes of Fee-for-Service and Capitated Medicaid Programs for People with Severe Mental Illness. Health Services Research, 37: 341–359. doi: 10.1111/1475-6773.026
- Issue published online: 3 SEP 2009
- Article first published online: 3 SEP 2009
- Severe mental illness;
Objective. To examine the effects of two models of capitation on the clinical outcomes of Medicaid beneficiaries in the state of Colorado.
Data Source. A large sample of adult, Medicaid beneficiaries with severe mental illness drawn from regions where capitation contracts were (1) awarded to local community mental health agencies (direct capitation), (2) awarded to a joint venture between local community mental health agencies and a large, private managed behavioral health organization, and (3) not awarded and care continued to be reimbursed on a fee-for-service basis.
Study Design. The three samples were compared on treatment outcomes assessed over 2 years (total n=591).
Data Collection Methods. Study participants were interviewed by trained, clinical interviewers using a standardized protocol consisting of the GAF, BPRS, QOLI, and CAGE.
Principal Findings. Outcomes were comparable across most outcome measures. When outcome differences were evident, they tended to favor the capitation samples.
Conclusions. Medicaid capitation in Colorado does not appear to have negatively affected the outcomes of people with severe mental illness during the first 2 years of the program. Furthermore, the type of capitation model was unrelated to outcomes in this study.