Goal: To develop a managed care or equivalent resource management system where stakeholder values, positive outcomes and quality services are on a par with cost containment and effectiveness.
Discussion
Developments within and outside Alaska have converged to require an analysis of the application of managed care to mental health services within the state. Nationally, managed care systems are sweeping through state and local public mental health systems, often touted as a way to curb skyrocketing entitlement and service provision costs. At the state level, the Legislature and other stakeholders are demanding greater accountability and cost effectiveness for public mental health services in an era of declining oil revenues.
The Alaska Mental Health Board seeks to avoid the mistakes made in many other states where managed care has been used strictly as a cost control mechanism. In many of these cases, managed care organizations have reduced client services and removed funds from the mental health system in the form of profits.
The Alaska Mental Health Board is now exploring whether the principles of managed care can be used to both improve care and control costs. For managed care to work in Alaska, cost considerations must be addressed concurrently with concerns for values, outcomes and quality services. In addition, there needs to be a process to involve consumers/families, providers and other stakeholders in the planning and development of a managed care system in Alaska.
To ensure this more balanced approach, the Alaska Mental Health Board has overseen two separate studies regarding managed mental health care and is considering the information in these reports in light of future policy and program development. The Board has also convened a broad-based Steering Committee to assist in overseeing the development of managed mental health care in Alaska.
Actions
275. The Alaska Mental Health Board will ensure that any future development adheres to the Board's December 12, 1997 position regarding the first managed care report, including the following principles for improving the mental health system:
a. Design and delivery of care must be based on consumers' goals, needs and preferences.
b. Any future arrangement must be built on current consumer, provider, departmental and system strengths.
c. A new system must organize around desired outcomes.
d. Desired outcomes should be promoted through risk and reward polices and actions.
e. Clinical and financial authority/responsibility must be more clearly aligned and responsive to the individualized needs of mental health consumers and their families.
276. The Managed Care Steering Committee and the Alaska Mental Health Board will review and develop positions on the second managed care report, received April 30, 1998.
277. The Alaska Mental Health Board, Department of Health and Social Services and other stakeholders will work together to consider and implement recommendations put forth by the Alaska Mental Health Board and the Managed Care Steering Committee.
Responsible party (actions 1-3): Alaska Mental Health Board, Department of Health and Social Services