MONITORING MENTAL-HEALTH-SERVICE CONTRACTS - 6 STATES EXPERIENCES

Objective: States finance some community-based mental health services through purchase-of-service contracts. The study examined ways in whic h six states monitor these contracts. Methods: Data were gathered duri ng site visits to Massachusetts, Michigan, New York, Oregon, Tennessee , and Texas, where more than 100 state policy makers, providers, consu mers, and advocates were interviewed about mental health purchase-of-s ervice contracting. Relevant documents about contracting practices for mental health services in each state were also examined. Results: Fin dings suggest that states monitor their mental health contracts in two ways, First, long-term contracts are monitor ed using traditional met hods, focusing on the structure and process of delivering services, Ne wer contracts for specific services are more likely to be monitored us ing performance measures currently being developed. States have had di fficulty cl eating and implementing performance-based contracting for publicly funded mental health services. Conclusions: It is likely that contracting will continue to be the method states use for future poli cy initiatives. It may be more appropriate for policy makers to set th eir sights: on developing a simplified set of outcome measures that wi ll give them some information about provider performance, even if the information is imperfect.