Correlates of Family Burden Under Medicaid Managed Mental Health Care

Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, 27599-7160, USA.
Administration and Policy in Mental Health and Mental Health Services Research (Impact Factor: 3.44). 12/2001; 29(2):117-28. DOI: 10.1023/A:1014384413652
Source: PubMed


This study examined predictors of family burden (assistance in daily living, supervision, and subjective concern) for family members of Medicaid recipients with severe mental illness in two regions of Virginia. In the Richmond area, mental health services were provided on a no-risk fee-for-service basis, while in Tidewater these services were provided through a risk-based capitated contract with a managed care organization. No differences in family burden were attributable to the risk-based payment system. Predictors of increased family burden were (a) more reported client symptoms and disruptive behaviors, (b) status as a parent, and (c) living with the client.

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    • "The Tidewater Managed Care Study (TMCS) was part of a SAMHSA managed care initiative that examined various models and arrangements of managed mental health care in the public sector (Leff et al. 2005). TMCS compared two different organizational and financing arrangements for services to adults with SMI who were enrolled in Medicaid in two regions of eastern Virginia (Fried et al. 2000; Isett et al. 2006; Morrissey et al. 2002; Stroup et al. 2001). In 1996 under a Sect. "
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    • "A significant proportion of persons with schizophrenia live with family members in both developing and developed countries , although nuclear families are becoming less common in industrialized countries. In the United States, families consistently feel more "burden" when they live with patients than when they live separately, and when patients have higher levels of symptoms (Stroup et al. 2001). For family members who live with someone with schizophrenia , the risk of violence is real (Estroff et al. 1998; Swanson et al. 1999). "
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