Does capitation affect the health of the chronically mentally ill?

Article Abstract:

Mentally-ill Medicaid patients who enroll in a prepaid plan such as an HMO may be no more likely to suffer from inadequate health care than those in a traditional fee-for-service plan. As part of a federally-sponsored plan to enroll Medicaid patients in prepaid plans, 35% of all Medicaid patients in Hennepin County, MN were assigned to a prepaid plan and the remainder were assigned to a fee-for-service plan. Of those with a chronic mental illness, 369 were in a prepaid plan and 370 were in a fee-for-service plan. They were tested for physical, social and psychiatric function at the time of the assignment and seven to 12 months later. At the end of the study there were no differences between the groups in measures of physical, social and psychiatric function. Slightly more patients in the prepaid group reported being turned away at emergency departments. They were also more likely to attempt suicide than those in the fee-for-service group.

Health aspects, Care and treatment, Mentally ill persons, Mentally ill, Capitated payment systems (Medical care)

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Health of the public: the private-sector challenge

Article Abstract:

There are 8 criteria that can be used to judge whether a managed care organization is socially responsible. The organization should enroll people who are representative of the local population. It should identify health problems in its community and develop appropriate programs to solve them. It should share its data with local health departments and other data repositories. It should publish data on its financial performance and the contributions it makes to the community. It should include local residents on its advisory boards and assist in the training of physicians. It should collaborate with medical schools and actively participate in disease prevention programs.

Standards, Corporate social responsibility

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Are all health plans created equal? The physician's view

Article Abstract:

Physicians appear to rate different types of health care plans differently and this information could be used by patients when choosing a plan. Researchers asked 100 physicians in one of three types of plans to rate one plan. Most rated their own plan. The plans included an HMO and two managed care plans, one of which used a primary care physician as a gatekeeper. On many measures, the HMO was rated more highly than the managed care plans. The managed care plan with a gatekeeper received the lowest rating on many measures. Only 24% of the physicians would recommend this plan to a family member, while 92% would recommend the HMO.

Evaluation, Physicians, Medical professions, Beliefs, opinions and attitudes, Health maintenance organizations

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