Outcomes for Medicaid beneficiaries with schizophrenia under a prepaid mental health carve-out

This study examines the impact of a mental health carve-out program in Utah on mental health status of Medicaid beneficiaries with schizophrenia. Thre e community mental health centers contracted to provide mental health care for all Medicaid beneficiaries in their service areas under managed care ar rangements, while beneficiaries in the remainder of the state remained unde r traditional Medicaid. A pre-past evaluation was utilized, with a contempo raneous control group of Utah Medicaid beneficiaries with schizophrenia und er traditional Medicaid. From 1991 to 1994, the average beneficiary's menta l health statics improved, but the improvement was less under the carve-out program than under traditional fee-for-service Medicaid. The difference wa s the greatest for beneficiaries with the worst mental health status at bas eline, with effects growing over time. Medicaid beneficiaries with schizoph renia experienced less improvement in mental health status under a carve-ou t arrangement for mental health care compared to what would have happened u nder traditional Medicaid.