Racial/ethnic disparities in admissions to public and private psychiatric inpatient settings: The effect of managed care

This study investigates the effect of managed care on access patterns among people of color who are severely and persistently mentally ill. The distri bution of admissions to public and private psychiatric hospitals was compar ed for African-American, Asian, Latino, and white case managed clients of t he Massachusetts Department of Mental Health before and after implementatio n of Medicaid managed mental health care in October 1997. Managed care appe ars to have increased access to private services across all racial and ethn ic groups, although admissions of non-white patients were still more likely to take place in publicly operated settings. These data suggest that equal izing access to putatively better inpatient treatment settings may be an ex ternality of managed care.