STATES EMBRACE OF MANAGED MENTAL-HEALTH-CARE

Historically, state mental health authorities have dominated public me ntal health services, operating with fixed resources and responsible f or a large population. A good public mental health system has many of the attributes of a well-managed private mental health system. Unfortu nately, public systems are not flexible enough to contract creatively with multiple providers; they lack many of the tools of modem managed care. As a consequence, state mental health authorities have begun to contract with private managed care firms to assist them in managing th eir health care reform efforts, particularly reform of Medicaid. This paper examines the forces shaping managed behavioral health care in th e public sector and describes strategies for managing care, such as co ntracting, utilization review, and monitoring.