Cost shifting in a mental health carve-out for the AFDC population.
Norton, Edward C
Date of Pub
Dickey, Barbara; Lindrooth, Richard C
This study tests whether the managed care vendor shifted costs to Medicaid-reimbursed medical care after the start of the
mental health carve-out for the Aid to Families with Dependent Children (AFDC) population in Massachusetts. We used claims
data over a 4-year period to estimate expenditures for four types of health services, two of which were paid for by the managed
care vendor and two by Medicaid. Total per person public expenditures declined by only about 3 percent. Inpatient psychiatric
services were replaced by outpatient psychiatric services and some pharmaceuticals, but overall there was little or no evidence
of cost shifting to the medical sector. These results are in contrast to what was found in a sample of Medicaid beneficiaries
eligible due to a mental health disability.
Adolescence : Adult : Aid to Families with Dependent Children/utilization : Child : Child, Preschool : Cost Allocation/statistics
& numerical data : Female : Health Expenditures/statistics & numerical data : Human : Infant : Male : Managed Care Programs/economics/utilization
: Massachusetts : Medicaid/organization & administration/statistics & numerical data : Mental Disorders/economics : Mental
Health Services/economics/utilization : Middle Age : Models, Econometric : Support, U.S. Gov't, P.H.S. : United States