Document Detail


Mental health services in the context of health insurance reform.
MedLine Citation:
PMID:  8413066     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Health care reform offers opportunities to improve the care of persons with serious mental illness, but it also can lead to the disruption of innovative systems of care that have been developed in recent years through Medicaid and other public programs. The care of mentally ill persons must be organized to maximize possible trade-offs between inpatient and other community services in a way that will promote function and satisfactory adjustment. An indemnity approach emphasizes controls on demand; instead, better design of supply-side approaches is required, using incentives to integrate services through case management and other methods. Considerable capacity development is needed to integrate long-term care appropriately into the mainstream, but serious barriers include control of risk selection and the difficulties of fairly adjusting capitation rates for high-utilization patients. Issues in mental health care are paradigmatic of many other areas of medical care and reflect changing family and community organizations and new challenges in care and rehabilitation.
Authors:
D Mechanic
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Milbank quarterly     Volume:  71     ISSN:  0887-378X     ISO Abbreviation:  Milbank Q     Publication Date:  1993  
Date Detail:
Created Date:  1993-11-18     Completed Date:  1993-11-18     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8607003     Medline TA:  Milbank Q     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  349-64     Citation Subset:  IM    
Affiliation:
Institute for Health, Health Care Policy, and Aging Research, Rutgers University, New Brunswick, NJ 08903.
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MeSH Terms
Descriptor/Qualifier:
Chronic Disease
Health Care Reform* / economics,  organization & administration
Health Maintenance Organizations
Health Services Needs and Demand
Humans
Insurance, Psychiatric*
Long-Term Care
Medicaid
Mental Health Services / economics*,  organization & administration
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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