Special Study on Managed Care

The special study on managed care was designed to track and analyze managed care reforms as they affect children and adolescents with emotional and substance abuse disorders and their families. The project entailed telephone interviews to three selected sites and site visits to three other selected sites. The primary purposes of the interviews and site visits were to:

assess the impact of managed care initiatives on children and adolescents with emotional disorders and their families through the lens of various stakeholders
assess the impact of managed care initiatives on the development and operation of local systems of care
explore how different groups of stakeholders view managed care reforms, the positive effects and the problems that have been created
begin to identify which aspects of the structure, design, organization, and characteristics of managed care systems have facilitated or created problems for mental health and substance abuse service delivery to children, adolescents, and their families
identify practical technical assistance for states and communities related to managed care for this population of children and families

Chart The sites studied included sites that had implemented managed care and had a base of experience to draw upon as well as sites that were in the stage of planning for and "positioning" for the implementation of managed care. Findings from this study will be useful at the Federal, state and local levels to refine managed care reforms and guide future reforms to be more responsive to the needs of children and adolescents with emotional and substance abuse disorders and their families.

Site visits and telephone interviews were completed during the spring and summer of 1997. The site visits were conducted by a two-person team for a two-day period. Interview guides addressed a range of domains related to managed care initiatives and their impact on children and adolescents with emotional disorders and their families. Interviews were conducted with six to seven small groups per site, including:

CMHS Project Director and key staff
Managed care purchasing/oversight agency
Managed care entity
Local mental health providers
Care managers/clinicians
Families
System-level interagency group

The interview list and schedule were created in conjunction with site representatives to best reflect the nature of the individual site. Analysis of information from the site visits and preparation of site visit reports are underway.

The project will culminate in a report that will synthesize information across sites and raise critical issues related to the implementation of managed care and the development of community-based systems of care for children and adolescents with serious emotional disorders and their families.

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