Medicaid Managed Care - U.S. Senate Special Committee on Aging

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Development of appropriate plans and providers requires a focus on the special
needs of persons with mental illness. Plans need the capacity to develop and obtain
the wide range of services needed by persons with mental illness. Benefits need to
be designed to provide sufficient accountability but still allow enough flexibility to
encourage plans to develop individualized, consumer-sensitive care approaches and
to overcome the institutional bias of fee-for-service <strong>Medicaid</strong>. Because persons with
mental illness need a range of services and supports, managed care programs should
maximize coordination with other services (educational, juvenile justice,
vocational, supportive, etc.) assisting the beneficiary.
Clear expectations, reflecting consumer input, must be monitored carefully. These
expectations must recognize that managed mental health care is a work in progress,
particularly regarding the appropriateness of rates and risk-sharing adjustments.
States will be challenged to develop effective systems of managed mental health
care. They need sufficient resources (staff, data capacity, quality oversight, consumer
and stakeholder involvement) to meet the task.
The National Academy for State Health Policy 0 © 8/97
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