Mental health in the Oregon Health Plan: fragmentation or integration?

摘要: The Oregon Health Plan was implemented in 1994 with a 50% expansion of Medicaid enrollment to include some the working poor. Over 75% clients are now enrolled health maintenance organizations (HMOs). Outpatient chemical dependency services have been capitated since May 1995. Capitated mental provided for 25% eligibles who live demonstration counties January Expansion and capitation appear achieved without major trauma. More challenging has attempted integration public sector behavioral private plans. Stakeholders interviewed this study were especially concerned about long-term impact on chronic illness. Strong leadership clear policies regarding mixture public, nonprofit, profit entities necessary if state is achieve its aim fragmenting system care people severe