CAPITATED PAYMENT SYSTEM FOR INVOLUNTARY CLIENTS

This research project takes advantage of a capitated payment system being
implemented in one catchment area of Oregon's mental health system. The
objective of the capitated payment system is to minimize state hospital
utilization by identified chronically mentally ill persons who are
frequent users of Oregon's involuntary treatment program. Capitated
payments will be for extra intensive community services. The proposed research will; (a) determine the expenditures associated
with the services delivered to these clients; (b) develop and test
alternative risk adjustment models which will allow payers and providers
to estimate the expenditures to be incurred in a given time period by a
given client: (c) evaluate an a priori risk adjustment model based on
client disability: and (d) test the generalizability of the risk
adjustment models by use of split sample and a comparison group. Predicator variables such as demographic and diagnostic characteristics
of clients and their prior utilization of state hospitals and community
programs will be extracted from the state information system and clinical
records. Subsequent client utilization of mental health services will be
tracked through the state information system and clinical records.
Subsequent client utilization of mental health services will be tracked
through the state information system and community and hospital records.
Costs of services will be found by analysis of agency budgets and by
tracking individual staff services. These costs will be regressed on the
predictor variables. This project will be conducted under the auspices of Oregon's newly
established Center for Research on the Organization and financing of Care
for the Severely Mentally ill the Western Mental Health Research Center.