SUPPORTED EMPLOYMENT AND MANAGED CARE - CAN THEY COEXIST

Some observers fear that increasing reliance on managed care and capit ated payment will reduce access to vocational rehabilitation services particularly bose provided within public mental health systems. Howeve r data from two studies suggest that under conditions of fiscal restra int vocational services could actually reduce costs. This article iden tifies the mechanisms by which costs might be reduced (improved functi oning and substitution), examines some preliminary evidence, ann discu sses the implications for integrated vocational services under managed care and/or capitated payment systems.