Beinecke R H, Goodman M, Lockhart A
Department of Public Management, Suffolk University, Boston, MA 02108, USA.
Adm Soc Work. 1997;21(2):41-53. doi: 10.1300/J147v21n02_03.
Medicaid managed care programs are becoming more widespread. To investigate the clinical, organizational, and financial impacts on service providers, a stratified, random sample of providers in the Massachusetts Managed Mental Health/Substance Abuse Program were surveyed by phone in Years 3 and 4 of the initiative. Providers reported that they were making widespread clinical changes such as more use of group, brief, and episodic therapies. They were increasing utilization review, Total Quality Management, and outcomes measurement. They were increasing in size, affiliating with other agencies, and providing a greater range of services. They were preparing for capitation. Compared to before the program and a year earlier, about 40 percent of providers were doing better financially and a quarter were doing worse. The study documents the hypothesis that a widespread and continuing transformation is taking place in response to managed care.
医疗补助管理式医疗计划正变得越来越普遍。为了调查对服务提供者的临床、组织和财务影响，在该计划的第3年和第4年，通过电话对马萨诸塞州管理式心理健康/药物滥用计划中的提供者进行了分层随机抽样调查。提供者报告说，他们正在进行广泛的临床变革，例如更多地使用团体、简短和阶段性治疗。他们在增加利用审查、全面质量管理和结果测量。他们的规模在扩大，与其他机构建立联系，并提供更广泛的服务。他们正在为按人头计费做准备。与该计划实施前和一年前相比，约40%的提供者财务状况有所改善，四分之一的提供者财务状况变差。该研究证明了这样一个假设，即针对管理式医疗正在发生广泛而持续的转变。
