Cost Containment and Mental Health Outcomes

Experiences from U.s. Studies

Published in: British Journal of Psychiatry, v. 166, Suppl 27, 1995, p. 43-51

Posted on RAND.org on January 01, 1995

by Kenneth B. Wells

From the findings of several RAND studies, including the HIE, the MOS, and the DRG Quality of Care Study, the author of this article concludes that cost containment for outpatient mental health care can be achieved through increasing the share of costs paid by the covered individual or through prepayment. Although quality of care may worsen for some vulnerable groups under some forms of prepaid health care, the DRG Quality of Care Study found that a national prospective payment mechanism was not associated with an overall marked drop in quality or outcomes of care among inpatient elderly depressed patients. The author concludes that although prepayment is not always associated with lower quality or outcomes for patients with depression, quality and outcomes of care should be monitored to identify possible adverse consequences, especially for those with the greatest psychological distress or those with the least ability to pay. Several RAND studies have shown that these groups of people are the most vulnerable to changes in health policy.

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