The Impact of Managed Care on Systems of Care That Serve Children With Serious Emotional Disturbances and Their Families

A qualitative case study approach was used to evaluate the impact of managed care reforms on a select sample of systems of care funded by the Comprehensive Community Mental Health Services for Children and Their Families Program. Analyses indicated that the system-of-care philosophy and approach could be maintained in a managed care environment under the right circumstances. These circumstances include (a) the preexistence of a system-of-care philosophy prior to the integration of managed care, (b) stakeholder involvement in managed care planning and implementation, (c) use of a broad array of providers and sufficient support for case management and care coordination activities, (d) identification and support of high utilizer groups within the managed care system, and (e) financial compatibility between managed care and systems of care.