Accountability for Reasonableness in Action: Public Sector Mental Health Contracting

Norman Daniels and James E. Sabin

in Setting Limits Fairly

Published in print March 2002 | ISBN: 9780195149364
Published online September 2009 | e-ISBN: 9780199865123 | DOI:
Accountability for Reasonableness in Action: Public Sector Mental Health Contracting

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This chapter looks at how public contracting for mental health care delivered by private, for-profit, managed care organizations can contain measures to ensure such accountability. Specifically, it examines how Massachusetts and Iowa sought to meet this challenge in their Medicaid mental health programs. The ultimate way for Massachusetts and Iowa to be accountable for the reasonableness of their mental health policies would be to demonstrate the positive impacts of their programs on the health of the insured populations, but, like the other forty-eight states, they have relatively skimpy outcome data. The contracting process between the two states and the managed mental health companies, however, still has much to teach about how to use contracting a vehicle for defining reasonable targets, holding the insurer accountable for the reasonableness of its performance, and setting limits in a way that can be seen as legitimate and fair.

Keywords: health care; managed care; Massachusetts; Iowa; Medicaid; mental health programs

Chapter.  5769 words. 

Subjects: Public Health and Epidemiology

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