Welfare Reform on the Web (October 1999): Mental Health Services - Overseas

ECONOMIC ASPECTS OF MENTAL HEALTH CARVE-OUTS

I. Vogelsang

Journal of Mental Health Policy and Economics, vol. 2, 1999, p. 29-41

Recent empirical research has found behavioural health carve-outs in the US to reduce costs immediately and considerably compared to indemnity insurance and HMOs. Paper uses concepts and results from industrial organisation and transaction cost literature to explain:

• why carve-outs hold cost advantages over other institutional arrangements;
• why these hold in particular for behavioural health;
• why this did not happen earlier.

MANAGED BEHAVIOURAL HEALTH CARE AND SUPPLY-SIDE ECONOMICS

R. M. Scheffler

Journal of Mental Health Policy and Economics, vol. 2, 1999, p. 21-28

Within the past decade, mental health care in the US has undergone a significant transformation in terms of delivery, financing and workforce configuration. Contracting between managed care organisations (MCOs) and providers has become increasingly prevalent, paralleling the trend in health care in general. As measured by changes in utilisation and price, widespread application of classic managed care techniques such as preadmission review, concurrent review, case management, standardised clinical protocols and guidelines, volume purchase of services and free discounting appear to have led to significant cost reductions for providers of both inpatient and outpatient mental health services.

SSI FOR CHILDREN WITH MENTAL DISORDERS: BACKGROUNDS AND A STUDY OF PARTICIPATION

M. N. Ozawa and B. E. Hong

Children and Youth Services Review, vol. 21, 1999, p. 437-462

The Personal Responsibility and Work Opportunity Reconciliation Act 1996 made it more difficult for children with disabilities to receive SSI (Supplemental Security Income). Article explores the question of whether SSI is being implemented for mentally disabled children as intended under the law. Findings of a study that investigated the relationship between rates of participation on account of mental illness and mental retardation and the prevalence of these disorders show that SSI is being implemented for children with learning difficulties according to the law, but not for children with mental illnesses.