EVALUATION OF THE UTAH PREPAID MENTAL HEALTH PLAN

拟议的研究旨在评估一项创新的 为医疗补助计划提供心理健康护理的融资和交付方法 项目受益人在犹他州。 犹他州，根据豁免， 卫生保健融资管理局已与三个社区签订合同， 心理健康中心（其服务领域包括所有医疗补助的52%） 受益人）提供精神卫生服务， 付款. 评价采用准实验设计， 与非合同网站提供不同的比较组 分析的方面。 分析将评估方案一级和 示范的基层成果。 在项目层面，它 将分析示威对医疗补助和CMHC的影响 业务、受益人的服务利用率和医疗补助 支出。 在受益者一级，它将估计 健康状况、可及性、满意度和利用率的示范 被诊断为精神分裂症的医疗补助受益人的样本。 分析单位随着研究问题的性质而变化， 在不同的时间，CMHC，医疗补助受益人，医疗补助 程序和个人治疗事件。 了各种定性和 提出了定量研究方法，利用各种 数据源，包括Medicaid和Medicare索赔文件、提供者 财务和使用记录，与Medicaid的面对面访谈 受益人，并与心理健康提供者进行面对面访谈， 医疗补助计划官员。 研究团队有经验， 主要是通过评估一个豁免的医疗补助示范， 明尼苏达州和兰德健康保险实验，与建议的数据 收集和分析方法。 评价代表了一个 明尼苏达大学研究人员的合作努力， 犹他州大学，并得到卫生保健司的全力支持 财政部，卫生部，犹他州，这已经资助了一个 精神分裂症医疗补助受益人的基线调查， 是研究设计的重要组成部分。

The proposed research seeks to evaluate the impact of an innovative approach to the financing and delivery of mental health care to Medicaid program beneficiaries in the State of Utah. Utah, under a waiver from the Health Care Financing Administration, has contracted with three community mental health centers (whose service areas include 52% of all Medicaid beneficiaries) to provide mental health services in return for capitated payments. The evaluation is structured as a quasi-experimental design, with non-contracting sites providing comparison groups for different aspects of the analysis. The analysis will assess both program-level and beneficiary-level outcomes of the demonstration. At the program level, it will analyze the impact of the demonstration on Medicaid and CMHC operations, service utilization rates for beneficiaries and Medicaid expenditures. At the beneficiary level, it will estimate the impact of the demonstration on health status, access, satisfaction, and utilization of services by a sample of Medicaid beneficiaries diagnosed as schizophrenic. The unit of analysis changes with the nature of the research question and is, at different times, the CMHC, the Medicaid beneficiary, the Medicaid program, and the individual treatment episode. A mix of qualitative and quantitative research methodologies are proposed, utilizing a variety of data sources including Medicaid and Medicare claims files, provider financial and utilization records, in-person interviews with Medicaid beneficiaries, and in-person interviews with mental health providers and Medicaid program officials. The research team has experience, acquired primarily through the evaluation of a waivered Medicaid demonstration in Minnesota and the RAND Health Insurance Experiment, with the proposed data collection and analytic approaches. The evaluation represents a collaborative effort of researchers at the University of Minnesota and University of Utah, and has the full support of the Division of Health Care Financing, Department of Health, State of Utah, which has already funded a baseline survey of schizophrenic Medicaid beneficiaries that is an essential component of the proposed research design.