Finance Strategies and Structures for Systems of Care

The Research and Training Center for Children's Mental Health has been studying financing structures for public behavioral health services for nearly two decades and has developed a host of empirically-based resources and tools for planners.

Over the past 15 years, states have increasingly relied on Medicaid to pay for health and mental health services. According to the 2003 State Survey of the Health Care Reform Tracking Project, 38 of the 50 states reported involvement in managed care activities that affected behavioral health services for children and their families. This trend mirrors reforms over the past two decades in the national health care delivery system.

Identifying Effective Funding Mechanisms

During the current grant cycle, the Center's Study 3: Financing Structures and Strategies to Support Effective Systems of Care will be the first to thoroughly investigate cross-agency financing structures and strategies, and will provide important information about finance policies that can assist communities across the country. This study has two primary research objectives: (a) using a case study design, we will test the validity of the theory that our hypothesized financing structures and strategies will support effective systems of care (b) we will investigate how these financing components operate separately and collectively within a community and systemic context, to create effective financing policy. The study also will investigate whether each financing component contributes to positive system-level outcomes. [more about the study]

The Health Care Reform Tracking Project

The Health Care Reform Tracking Project was initiated to track and analyze the impact of Medicaid managed care reforms on children and adolescents with serious emotional disturbances and their families. Work on the Health Care Tracking Project began in 1995 when a team of researchers began a study of the impact of behavioral health managed care on children and adolescents with emotional and behavioral disorders. The Tracking Project conducted an initial baseline survey of all 50 states and the District of Columbia in 1995, which identified 44 states with managed care activities underway at various stages. Eventually, four all-state surveys were conducted, followed by impact analyses. By 1999, the research was expanded to consider substance abuse and child welfare issues.

Mary Armstrong, Ph.D.
Louis de la Parte Florida Mental Health Institute - MHC 2333
13301 Bruce B. Downs Blvd.
Tampa, FL 33612