Community-level changes in behavioral health care following capitated contracting

As capitated managed care contracts are becoming more prevalent in the deli very of behavioral health services, it is important to review community exp eriences with these contracts. A survey of all community agencies in one ar ea that provided or interacted with behavioral health services for children and adolescents was administered during the implementation of a clinically -managed demonstration and again four years later after the transition to a capitated managed care contract. The following changes were reported under the capitated contract: a) problems in service delivery experienced by the target population increased; b) quality of behavioral health and related s ervices available decreased; (c) service system performance decreased, (d) the extent to which goals of an effective behavioral health service system were being attained was also rated as significantly decreased; and (e) coor dination of services for the target population and collaboration among prov iders declined.