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Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research 4/2006

01.07.2006

Outcomes for Rural Medicaid Clients with Severe Mental Illness in Fee for Service versus Managed Care

verfasst von: Jacqueline M. Bianconi, Jo M. Mahler, Bentson H. McFarland

Erschienen in: Administration and Policy in Mental Health and Mental Health Services Research | Ausgabe 4/2006

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Abstract

This study compared outcomes for rural Medicaid clients with severe mental illness in fee for service versus managed care programs. Interviews were conducted with 305 Medicaid clients in rural Oregon (166 in fee for service and 139 in managed care). Logistic and multivariate regression analyses were used to examine client satisfaction, safety, symptoms, functioning, and family satisfaction in the fee for service versus managed care groups. There was no evidence that conversion of the Medicaid mental health system from fee for service to managed care led to changes in outcomes for rural clients with severe mental illness.
Literatur
Zurück zum Zitat Agency for Health Care Policy and Research, Center for Mental Health Services Research and Battelle/Survey Research Association. (1995). Schizophrenia PORT Inpatient Record. Baltimore, MD. Agency for Health Care Policy and Research, Center for Mental Health Services Research and Battelle/Survey Research Association. (1995). Schizophrenia PORT Inpatient Record. Baltimore, MD.
Zurück zum Zitat Alegrie, M., McGuire, T., & Vera, M. (2001a). Changes in access to mental health care among the poor and nonpoor: Results from the health care reform in Puerto Rico. American Journal of Public Health, 91, 1431–1432.CrossRef Alegrie, M., McGuire, T., & Vera, M. (2001a). Changes in access to mental health care among the poor and nonpoor: Results from the health care reform in Puerto Rico. American Journal of Public Health, 91, 1431–1432.CrossRef
Zurück zum Zitat Alegrie, M., McGuire, T., Vera, M., Canino, G., Freeman, D., Matias, L., Albizu, C., Marin, H., & Calderon, J. (2001b). The impact of managed care on the use of outpatient mental health and substance abuse services in Puerto Rico. Inquiry, 38, 381–395. Alegrie, M., McGuire, T., Vera, M., Canino, G., Freeman, D., Matias, L., Albizu, C., Marin, H., & Calderon, J. (2001b). The impact of managed care on the use of outpatient mental health and substance abuse services in Puerto Rico. Inquiry, 38, 381–395.
Zurück zum Zitat Barker, S., Barron, N., McFarland, B. H., & Bigelow, D. A. (1994a). A community ability scale for chronically mentally ill consumers: Part I, reliability and validity. Community Mental Health Journal, 30, 363–383.CrossRef Barker, S., Barron, N., McFarland, B. H., & Bigelow, D. A. (1994a). A community ability scale for chronically mentally ill consumers: Part I, reliability and validity. Community Mental Health Journal, 30, 363–383.CrossRef
Zurück zum Zitat Barker, S., Barron, N., McFarland, B. H., Bigelow, D. A., & Carnahan, T. (1994b). A community ability scale for chronically mentally ill consumers: Part II, applications. Community Mental Health Journal, 30, 459–472.CrossRef Barker, S., Barron, N., McFarland, B. H., Bigelow, D. A., & Carnahan, T. (1994b). A community ability scale for chronically mentally ill consumers: Part II, applications. Community Mental Health Journal, 30, 459–472.CrossRef
Zurück zum Zitat Bjorklund R. W., & Pippard, J. L. (1999). The mental health consumer movement: Implications for rural practice. Community Mental Health Journal, 35, 347–359.CrossRefPubMed Bjorklund R. W., & Pippard, J. L. (1999). The mental health consumer movement: Implications for rural practice. Community Mental Health Journal, 35, 347–359.CrossRefPubMed
Zurück zum Zitat Blank, M. B., Eisenber, M. M., Hargrove, D. S., & Fox, J. C. (1996). Introduction to special issue: Health care reform and rural special populations. Community Mental Health Journal, 32, 427.CrossRef Blank, M. B., Eisenber, M. M., Hargrove, D. S., & Fox, J. C. (1996). Introduction to special issue: Health care reform and rural special populations. Community Mental Health Journal, 32, 427.CrossRef
Zurück zum Zitat Bloom, J. R., Hu, T., Wallace, N., Cuffel, B., Hausman, J. W., Sheu, M., & Scheffler, R. (2002). Mental health costs and access under alternative capitation systems in Colorado. Health Services Research, 37, 315–340.CrossRefPubMed Bloom, J. R., Hu, T., Wallace, N., Cuffel, B., Hausman, J. W., Sheu, M., & Scheffler, R. (2002). Mental health costs and access under alternative capitation systems in Colorado. Health Services Research, 37, 315–340.CrossRefPubMed
Zurück zum Zitat Boothroyd, R. A., Shern, D. L., & Bell, N. L. (2002). The effect of financial risk arrangements on service access and satisfaction among Medicaid beneficiaries. Psychiatric Services, 53, 299–303.CrossRefPubMed Boothroyd, R. A., Shern, D. L., & Bell, N. L. (2002). The effect of financial risk arrangements on service access and satisfaction among Medicaid beneficiaries. Psychiatric Services, 53, 299–303.CrossRefPubMed
Zurück zum Zitat Bouchery, E., & Harwood, H. (2003). The Nebraska Medicaid managed behavioral health care initiative: impacts on utilization, expenditures, and quality of care for mental health. Journal of Behavioral Health Services and Research, 30, 93–108.CrossRefPubMed Bouchery, E., & Harwood, H. (2003). The Nebraska Medicaid managed behavioral health care initiative: impacts on utilization, expenditures, and quality of care for mental health. Journal of Behavioral Health Services and Research, 30, 93–108.CrossRefPubMed
Zurück zum Zitat Buck, J. A. (2001). Managed mental health care in Medicaid: Does the solution match the problem? Administration and Policy in Mental Health, 29, 177–180.CrossRefPubMed Buck, J. A. (2001). Managed mental health care in Medicaid: Does the solution match the problem? Administration and Policy in Mental Health, 29, 177–180.CrossRefPubMed
Zurück zum Zitat Chang, C. F., Kiser, L. J., Bailey, J. E., Martins, M., Gibson, W. C., Schaberg, K. A., Mirvis, D. M., & Applegate, W. B. (1998). Tennessee’s failed managed care program for mental health and substance abuse services. Journal of the American Medical Association, 279, 864–869.CrossRefPubMed Chang, C. F., Kiser, L. J., Bailey, J. E., Martins, M., Gibson, W. C., Schaberg, K. A., Mirvis, D. M., & Applegate, W. B. (1998). Tennessee’s failed managed care program for mental health and substance abuse services. Journal of the American Medical Association, 279, 864–869.CrossRefPubMed
Zurück zum Zitat Clay, R. A. (2005): Financing health care: Understanding Medicaid. SAMHSA News, 13(1), 1–5. Rockville, Maryland: Substance Abuse and Mental Health Services Administration (January/February, 2005). Clay, R. A. (2005): Financing health care: Understanding Medicaid. SAMHSA News, 13(1), 1–5. Rockville, Maryland: Substance Abuse and Mental Health Services Administration (January/February, 2005).
Zurück zum Zitat Cutler, D. L., Bigelow, D., & McFarland, B. (1992). The cost of fragmented mental health financing: Is it worth it? Community Mental Health Journal, 28, 121–133.CrossRefPubMed Cutler, D. L., Bigelow, D., & McFarland, B. (1992). The cost of fragmented mental health financing: Is it worth it? Community Mental Health Journal, 28, 121–133.CrossRefPubMed
Zurück zum Zitat Deck, D. D., McFarland, B. H., Titus, J. M., Laws, K. E., & Gabriel, R. M. (2000). Access to substance abuse treatment services under the Oregon Health Plan. Journal of the American Medical Association, 284, 2093–2099.CrossRefPubMed Deck, D. D., McFarland, B. H., Titus, J. M., Laws, K. E., & Gabriel, R. M. (2000). Access to substance abuse treatment services under the Oregon Health Plan. Journal of the American Medical Association, 284, 2093–2099.CrossRefPubMed
Zurück zum Zitat Derogatis, L. R. (1993). Brief Symptom Inventory (BSI). A brief form of the SCL-90-R, a self-report symptom inventory designed to measure psychological stress (3rd ed.). Minneapolis, Minn: National Computer Systems. Derogatis, L. R. (1993). Brief Symptom Inventory (BSI). A brief form of the SCL-90-R, a self-report symptom inventory designed to measure psychological stress (3rd ed.). Minneapolis, Minn: National Computer Systems.
Zurück zum Zitat Dickey, B., Normand, S. T., Hermann, R. C., Eisen, S. V., Cortes, D. E., Cleary, P. D., & Ware, N. (2003). Guideline recommendations for treatment of schizophrenia: The impact of managed care. Archives of General Psychiatry, 60, 340–348.CrossRefPubMed Dickey, B., Normand, S. T., Hermann, R. C., Eisen, S. V., Cortes, D. E., Cleary, P. D., & Ware, N. (2003). Guideline recommendations for treatment of schizophrenia: The impact of managed care. Archives of General Psychiatry, 60, 340–348.CrossRefPubMed
Zurück zum Zitat Ettner, S. L., Argeriou, M., McCarty, D., Dilornardo, J., & Liu,H. (2003). How did the introduction of managed care for the uninsured in Iowa affect the use of substance abuse services? Journal of Behavioral Health Services Research, 30, 26–40.CrossRefPubMed Ettner, S. L., Argeriou, M., McCarty, D., Dilornardo, J., & Liu,H. (2003). How did the introduction of managed care for the uninsured in Iowa affect the use of substance abuse services? Journal of Behavioral Health Services Research, 30, 26–40.CrossRefPubMed
Zurück zum Zitat The Evaluation Center at HSRI. (1996). Cross-Disability Integrated Health Outcomes Survey (CDIHOS). Cambridge, Mass: CW Beane. The Evaluation Center at HSRI. (1996). Cross-Disability Integrated Health Outcomes Survey (CDIHOS). Cambridge, Mass: CW Beane.
Zurück zum Zitat Findlay, S. (1999). Managed behavioral health care in 1999: An industry at a crossroads. Health Affairs, 18, 116–124.CrossRefPubMed Findlay, S. (1999). Managed behavioral health care in 1999: An industry at a crossroads. Health Affairs, 18, 116–124.CrossRefPubMed
Zurück zum Zitat Frank, R. G. (2000). The creation of Medicare and Medicaid: The emergence of insurance and markets for mental health services. Psychiatric Services, 51, 465–468.CrossRefPubMed Frank, R. G. (2000). The creation of Medicare and Medicaid: The emergence of insurance and markets for mental health services. Psychiatric Services, 51, 465–468.CrossRefPubMed
Zurück zum Zitat Goetz, R., McFarland, B., & Ross, K. (2000). Lessons learned. In R. R. Goetz, B. H. McFarland & K. V. Ross (Eds.), What the Oregon Health Plan can teach us about managed mental health care. New Directions for Mental Health Services, Vol. 85 (pp. 7–16). San Francisco, CA: Jossey-Bass. Goetz, R., McFarland, B., & Ross, K. (2000). Lessons learned. In R. R. Goetz, B. H. McFarland & K. V. Ross (Eds.), What the Oregon Health Plan can teach us about managed mental health care. New Directions for Mental Health Services, Vol. 85 (pp. 7–16). San Francisco, CA: Jossey-Bass.
Zurück zum Zitat Goldman, W., McCulloch, J., Cuffel, B., & Cozma, D. (1999). More evidence for the insurability of managed behavioral health care. Health Affairs, 18, 172–181.CrossRefPubMed Goldman, W., McCulloch, J., Cuffel, B., & Cozma, D. (1999). More evidence for the insurability of managed behavioral health care. Health Affairs, 18, 172–181.CrossRefPubMed
Zurück zum Zitat Leff, S., Mulkern, V., Lieberman, M., & Raab, B. (1994). The effects of capitation on service access, adequacy, and appropriateness. Administration and Policy in Mental Health, 21, 141–160.CrossRef Leff, S., Mulkern, V., Lieberman, M., & Raab, B. (1994). The effects of capitation on service access, adequacy, and appropriateness. Administration and Policy in Mental Health, 21, 141–160.CrossRef
Zurück zum Zitat Leff, H. S., Wieman, D. A., McFarland, B. H., Morrissey, J. P., Rothbard, A., Shern, D. L., Wylie, A. M., Boothroyd, R. A., Stroup, T. S., & Allen, I. E. (2005). The effects of Medicaid managed behavioral health care on persons with severe mental illness. Psychiatric Services, 56, 1245–1253.CrossRefPubMed Leff, H. S., Wieman, D. A., McFarland, B. H., Morrissey, J. P., Rothbard, A., Shern, D. L., Wylie, A. M., Boothroyd, R. A., Stroup, T. S., & Allen, I. E. (2005). The effects of Medicaid managed behavioral health care on persons with severe mental illness. Psychiatric Services, 56, 1245–1253.CrossRefPubMed
Zurück zum Zitat Lehman, A. (1988). A quality of life interview for the chronically mentally ill. Evaluation and Program Planning, 11, 51–62.CrossRef Lehman, A. (1988). A quality of life interview for the chronically mentally ill. Evaluation and Program Planning, 11, 51–62.CrossRef
Zurück zum Zitat Lurie, N., Moscovice, I. S., Finch, M., Christianson, J. B., & Popkin, M. K. (1992). Does capitation affect the health of the chronically mentally ill? Results from a randomized trial. Journal of the American Medical Association, 267, 3300–3303.CrossRefPubMed Lurie, N., Moscovice, I. S., Finch, M., Christianson, J. B., & Popkin, M. K. (1992). Does capitation affect the health of the chronically mentally ill? Results from a randomized trial. Journal of the American Medical Association, 267, 3300–3303.CrossRefPubMed
Zurück zum Zitat Manning, W. G., Liu, C., & Stoner, T. J. (1999). Outcomes for Medicaid beneficiaries with schizophrenia under a prepaid mental health carve-out. Journal of Behavioral Health Services and Research, 26, 442–450.CrossRefPubMed Manning, W. G., Liu, C., & Stoner, T. J. (1999). Outcomes for Medicaid beneficiaries with schizophrenia under a prepaid mental health carve-out. Journal of Behavioral Health Services and Research, 26, 442–450.CrossRefPubMed
Zurück zum Zitat McFarland, B. H. (2000). Overview of Medicaid managed behavioral health care. In R. R. Goetz, B. H. McFarland & K. V. Ross (Eds.), What the Oregon Health Plan can teach us about managed mental health care. New Directions for Mental Health Services. San Francisco: Jossey-Bass, No. 85. McFarland, B. H. (2000). Overview of Medicaid managed behavioral health care. In R. R. Goetz, B. H. McFarland & K. V. Ross (Eds.), What the Oregon Health Plan can teach us about managed mental health care. New Directions for Mental Health Services. San Francisco: Jossey-Bass, No. 85.
Zurück zum Zitat McFarland, B. H., Deck, D. D., McCamant, L. E., Gabriel, R. M., & Bigelow, D. A. (2005). Outcomes for Medicaid clients with substance abuse problems before and after managed care. Journal of Behavioral Health Services and Research, 32, 351–367.CrossRefPubMed McFarland, B. H., Deck, D. D., McCamant, L. E., Gabriel, R. M., & Bigelow, D. A. (2005). Outcomes for Medicaid clients with substance abuse problems before and after managed care. Journal of Behavioral Health Services and Research, 32, 351–367.CrossRefPubMed
Zurück zum Zitat McFarland, B. H., & George, R. A. (1995). Ethics and managed care. Child and Adolescent Psychiatric Clinics of North America, 4, 885–901. McFarland, B. H., & George, R. A. (1995). Ethics and managed care. Child and Adolescent Psychiatric Clinics of North America, 4, 885–901.
Zurück zum Zitat McLellan, A. T., Luborsky, L., Woody, G. E., & O’Brien, C. P. (1980). The Addiction Severity Index: An improved diagnostic instrument for substance use patients. Journal of Nervous and Mental Disorders, 168, 26–33.CrossRef McLellan, A. T., Luborsky, L., Woody, G. E., & O’Brien, C. P. (1980). The Addiction Severity Index: An improved diagnostic instrument for substance use patients. Journal of Nervous and Mental Disorders, 168, 26–33.CrossRef
Zurück zum Zitat Mechanic, D. (2003a). Editorial: Managing behavioral health in Medicaid. New England Journal of Medicine, 348, 1914–1916.CrossRef Mechanic, D. (2003a). Editorial: Managing behavioral health in Medicaid. New England Journal of Medicine, 348, 1914–1916.CrossRef
Zurück zum Zitat Mechanic, D. (2003b). Policy changes in improving mental health services: some lessons from the past. Psychiatric Services, 54, 1227–1232.CrossRef Mechanic, D. (2003b). Policy changes in improving mental health services: some lessons from the past. Psychiatric Services, 54, 1227–1232.CrossRef
Zurück zum Zitat Mental Health Statistics Improvement Program Task Force on a Consumer-Oriented Mental Health Report Card. (1996). The MHSIP Consumer-Oriented Mental Health Report Card. Rockville, MD: Center for Mental Health Services. Mental Health Statistics Improvement Program Task Force on a Consumer-Oriented Mental Health Report Card. (1996). The MHSIP Consumer-Oriented Mental Health Report Card. Rockville, MD: Center for Mental Health Services.
Zurück zum Zitat Morrissey J. P., Stroup T. S., Ellis A. R., & Merwin, E. (2002). Service use and health status of persons with severe mental illness in full-risk and non-risk Medicaid programs. Psychiatric Services, 53, 293–298.CrossRefPubMed Morrissey J. P., Stroup T. S., Ellis A. R., & Merwin, E. (2002). Service use and health status of persons with severe mental illness in full-risk and non-risk Medicaid programs. Psychiatric Services, 53, 293–298.CrossRefPubMed
Zurück zum Zitat Murray, J. D., & Keller, P. A. (1991). Psychology and rural America. American Psychologist, 46, 220–231.CrossRefPubMed Murray, J. D., & Keller, P. A. (1991). Psychology and rural America. American Psychologist, 46, 220–231.CrossRefPubMed
Zurück zum Zitat O’Malia, L., McFarland, B. H., Barker, S., & Barron, N. M. (2002). A level-of-functioning self-report measure for consumers with severe mental illness. Psychiatric Services, 53, 326–331.CrossRefPubMed O’Malia, L., McFarland, B. H., Barker, S., & Barron, N. M. (2002). A level-of-functioning self-report measure for consumers with severe mental illness. Psychiatric Services, 53, 326–331.CrossRefPubMed
Zurück zum Zitat Ray, W. A., Daugherty, J. R., & Meador, K. G. (2003). Effect of a mental health “carve-out” program on the continuity of antipsychotic therapy. New England Journal of Medicine, 348, 1885–1894.CrossRefPubMed Ray, W. A., Daugherty, J. R., & Meador, K. G. (2003). Effect of a mental health “carve-out” program on the continuity of antipsychotic therapy. New England Journal of Medicine, 348, 1885–1894.CrossRefPubMed
Zurück zum Zitat Ridgely, M. S., Mulkern, V., Giard, J., & Shern, D. (2002). Critical elements of public-sector managed behavioral health programs for severe mental illness in five states. Psychiatric Services, 53, 397–399.CrossRefPubMed Ridgely, M. S., Mulkern, V., Giard, J., & Shern, D. (2002). Critical elements of public-sector managed behavioral health programs for severe mental illness in five states. Psychiatric Services, 53, 397–399.CrossRefPubMed
Zurück zum Zitat Rohland, B. M. (1998). Implementation of Medicaid managed mental health care in Iowa: Problems and solutions. Journal of Behavioral Health Services and Research, 25, 293–300.CrossRefPubMed Rohland, B. M. (1998). Implementation of Medicaid managed mental health care in Iowa: Problems and solutions. Journal of Behavioral Health Services and Research, 25, 293–300.CrossRefPubMed
Zurück zum Zitat Rohland B. M. (1999). Quality assessment in a Medicaid managed mental health care plan: An Iowa case study. American Journal of Orthopsychiatry, 69, 410–414.PubMedCrossRef Rohland B. M. (1999). Quality assessment in a Medicaid managed mental health care plan: An Iowa case study. American Journal of Orthopsychiatry, 69, 410–414.PubMedCrossRef
Zurück zum Zitat Ross, K. V., & McFarland, B. H. (2000). The mental health organizations. In R. R. Goetz., B. H. McFarland., & K. V. Ross (Eds.), What the Oregon Health Plan can teach us about managed mental health care. New Directions for Mental Health Services, Vol. 85 (pp. 57–64). San Francisco: Jossey-Bass. Ross, K. V., & McFarland, B. H. (2000). The mental health organizations. In R. R. Goetz., B. H. McFarland., & K. V. Ross (Eds.), What the Oregon Health Plan can teach us about managed mental health care. New Directions for Mental Health Services, Vol. 85 (pp. 57–64). San Francisco: Jossey-Bass.
Zurück zum Zitat Rothbard, A. B., Kuno, E., Hadley, T. R., & Dogin, J. (2004). Psychiatric service utilization and cost for persons with schizophrenia in a Medicaid managed care program. Journal of Behavioral Health Services and Research, 31, 1–12.CrossRefPubMed Rothbard, A. B., Kuno, E., Hadley, T. R., & Dogin, J. (2004). Psychiatric service utilization and cost for persons with schizophrenia in a Medicaid managed care program. Journal of Behavioral Health Services and Research, 31, 1–12.CrossRefPubMed
Zurück zum Zitat Rothbard, A. B., McFarland, B. H., Shern, D. L., Morrissey, J., Sleff, S., & Wylie, M. (2002). Managed care for persons with serious mental illness. Drug Benefit Trends, 14, 6–14. Rothbard, A. B., McFarland, B. H., Shern, D. L., Morrissey, J., Sleff, S., & Wylie, M. (2002). Managed care for persons with serious mental illness. Drug Benefit Trends, 14, 6–14.
Zurück zum Zitat Stamm, B. H. (2003). Behavioral healthcare in rural and frontier areas: An interdisciplinary handbook. Washington, DC: APA Books. Stamm, B. H. (2003). Behavioral healthcare in rural and frontier areas: An interdisciplinary handbook. Washington, DC: APA Books.
Zurück zum Zitat Stroup, T. S., & Dorwart, R. A. (1995). Impact of a managed mental health program on Medicaid recipients with severe mental illness. Psychiatric Services, 46, 885–889.PubMed Stroup, T. S., & Dorwart, R. A. (1995). Impact of a managed mental health program on Medicaid recipients with severe mental illness. Psychiatric Services, 46, 885–889.PubMed
Zurück zum Zitat Sullivan, F., Jackson, C. A., Spritzer, K. L. Characteristics and service use of seriously mentally ill persons living in rural areas. Psychiatric Services, 47, 57–61.PubMed Sullivan, F., Jackson, C. A., Spritzer, K. L. Characteristics and service use of seriously mentally ill persons living in rural areas. Psychiatric Services, 47, 57–61.PubMed
Zurück zum Zitat Tessler, R. C., & Gamache, G. (1996). The Family Burden Interview Schedule – Short Form (FBIS/SF). In L. I. Sederer & B. Dickey (Eds.), Outcomes assessment in clinical practice. Baltimore: Williams and Wilkins. Tessler, R. C., & Gamache, G. (1996). The Family Burden Interview Schedule – Short Form (FBIS/SF). In L. I. Sederer & B. Dickey (Eds.), Outcomes assessment in clinical practice. Baltimore: Williams and Wilkins.
Zurück zum Zitat United States Bureau of the Census. (2000). United States Department of Commerce, Census of Population and Housing. United States Bureau of the Census. (2000). United States Department of Commerce, Census of Population and Housing.
Zurück zum Zitat Ware, J. Jr., Kosinski, M., & Keller, S. D. (1996). A 12-item Short Form Helath Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.CrossRefPubMed Ware, J. Jr., Kosinski, M., & Keller, S. D. (1996). A 12-item Short Form Helath Survey: Construction of scales and preliminary tests of reliability and validity. Medical Care, 34, 220–233.CrossRefPubMed
Zurück zum Zitat Warner, R., & Huxley, P. (1998). Outcome for people with schizophrenia before and after Medicaid capitation at a community agency in Colorado. Psychiatric Services, 49, 802–810.PubMed Warner, R., & Huxley, P. (1998). Outcome for people with schizophrenia before and after Medicaid capitation at a community agency in Colorado. Psychiatric Services, 49, 802–810.PubMed
Zurück zum Zitat Weiss, R. L., Battaglia, J., & Epstein, R. S. (1999). Frontier ethics: mental health care needs and ethical dilemmas in rural communities. Psychiatric Services, 50, 497–503.PubMed Weiss, R. L., Battaglia, J., & Epstein, R. S. (1999). Frontier ethics: mental health care needs and ethical dilemmas in rural communities. Psychiatric Services, 50, 497–503.PubMed
Metadaten
Titel
Outcomes for Rural Medicaid Clients with Severe Mental Illness in Fee for Service versus Managed Care
verfasst von
Jacqueline M. Bianconi
Jo M. Mahler
Bentson H. McFarland
Publikationsdatum
01.07.2006
Verlag
Springer US
Erschienen in
Administration and Policy in Mental Health and Mental Health Services Research / Ausgabe 4/2006
Print ISSN: 0894-587X
Elektronische ISSN: 1573-3289
DOI
https://doi.org/10.1007/s10488-006-0041-7

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