PRIVATIZED MEDICAID MANAGED CARE IN MASSACHUSETTS - DISPOSITION IN CHILD AND ADOLESCENT MENTAL-HEALTH EMERGENCIES

Data from child and adolescent emergency mental health screening episo des prior and subsequent to privatized Medicaid managed care in Massac husetts are used to investigate the relationship between payer source and disposition and to compare the match between clinical need and dis position level of care. Having Medicaid as the payer in the post-Medic aid managed care period decreased the odds of hospitalization by nearl y 60%, None of the clinical need variables that contributed to hospita lization for Medicaid episodes in the pre-Medicaid managed care period were significant in the post-Medicaid managed care period Multiple fo rces shaping professional standards, decision making, and quality of c are are described Public sector agencies must lay the groundwork for c omprehensive evaluation prior to the implementation of privatized Medi caid managed care initiatives.