Colorado’s capitated mental health program now operates in 51 counties, offering services to about 189, 000 of the state’s 274,000 Medicaid eligibles. The state estimates that the cost of inpatient psychiatric hospital services dropped by more than two-thirds to $9.8 million in fiscal 1996 from $30.1 million in fiscal 1995, the last year of fee-for-service. Capitated Medicaid expenditures for outpatient, residential and other services such as respite care, school-based services, drop-in centers, and teen mother’s programs, jumped to $46.9 million from $29.5 million over the same period.
Other key facts cited in a recent report to the state legislature include:
• During fiscal 1995-’96, the first year of managed care, the percentage of total resources spent on inpatient services declined to 17.2% from 50.6% a year earlier. The number of in-patient days dropped to 19,959 from 93,151. The percentage spent on all other services soared to 82.% from 49.4%.
• The number of individuals waiting at least two weeks for services decreased from 1,314 in April 1996 to 973 in September 1996.
But Paul Sherman, a behavioral health care consultant and a former acting deputy commissioner in the state’s Division of Mental Health, says the state actually has 35% less money to buy services over the first two years of the program than it had under fee-for-service. Along with the lower amount the state is paying under capitation, there are administrative costs, profits earned by the for-profit, Options Mental Health and reserves put aside by the MHASAs taking dollars out of services.
"Now that we have pulled a third of the dollars out of the system, I’m not optimistic that things are that rosy," he says. Bill Bush, the state’s capitation program manager, says Mr. Sherman’s numbers are greatly inflated, adding that he fails to account for many expenses the state had previously under fee-for-service.
Contact Mr. Sherman at 303-273-2741.
Colorado officials say numbers reflect programs success
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