Community-level changes in behavioral health care following capitated contracting

Abstract

As capitated managed care contracts are becoming more prevalent in the delivery of behavioral health services, it is important to review community experiences with these contracts. A survey of all community agencies in one area that provided or interacted with behavioral health services for children and adolescents was administered during the implementation of a clinically-managed demonstration and again four years later after the transition to a capitated managed care contract. The following changes were reported under the capitated contract: 1. a) problems in service delivery experienced by the target population increased; 2. b) quality of behavioral health and related services available decreased; 3. (c) service system performance decreased, 4. (d) the extent to which goals of an effective behavioral health service system were being attained was also rated as significantly decreased; and 5. (e) coordination of services for the target population and collaboration among providers declined.