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Special Report
Contracting for Public Mental Health
Services Opinions of Managed
Behavioral Health Care Organizations
Approach to the Study
This report synthesizes the collective experiences of four MBHOs1
that hold contracts for public sector, managed care carve-outs. Together, the four MBHOs enroll over 106 million members and constitute more than 60 percent of the entire managed behavioral
health care market (Findlay, 1999). Four experienced representatives from these MBHOs participated in a daylong focus group meeting. Two additional representatives were interviewed by telephone.
To ensure that the representatives would be able to draw on experience from different
settings, the organizations invited to participate included those that have operated
several public programs in different States. The four MBHOs (American Psych Systems,
Magellan, United Behavioral Health, and ValueOptions) have significant experience providing managed behavioral health services for Medicaid and general assistance carveout programs.2 Over 70 percent of the 21 States with Medicaid carve-outs for behavioral health services contract with these four MBHOs, who manage the mental health benefits for almost 2.5 million Medicaid recipients (Croze, 1998; Lewin Group, 1999).
Participants were briefed on the purpose of the meeting and ideas for specific discussion topics were solicited in advance. The agenda for the discussion covered program design (e.g., benefit package, financial requirements), procurement processes, and program administration and oversight. To promote a frank discussion of the issues, the meeting adhered to the following guidelines concerning the use of information and intent for any written report:
Participants would be permitted to comment
on this report before completion of
the final draft.
The names of specific participants would
not be linked to their comments in the
final report.
Specific public programs discussed in the
meetings as examples of problems would
not be divulged.
Specific programs put forth by participants
as examples of successful design
or implementation could be identified in
the report.
The views presented in the following sections
are solely those of the study participants.
They do not necessarily represent the
policies or opinions of the Center for Mental
Health Services or the Substance Abuse and
Mental Health Services Administration.
1See the Appendix for a complete list of focus group participants.
2One MBHO representative is currently with Menninger Care Systems, an MBHO that focuses on private sector clients. However, the representative participating had extensive public sector experience through her prior employment at United Behavioral Health.
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