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Related Experiment Videos

Methodology for evaluating the Monroe-Livingston capitation system.

H M Babigian1, R E Cole, S K Reed

  • 1Department of Psychiatry, University of Rochester Medical Center, New York 14642.

Hospital & Community Psychiatry
|September 1, 1991
PubMed
Summary

This study evaluated a capitation payment system (CPS) for individuals with chronic mental illness. The methodology focused on patient outcomes and resource use within a randomized controlled trial design.

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Area of Science:

  • Health Services Research
  • Mental Health Policy
  • Healthcare Economics

Background:

  • The Monroe-Livingston demonstration project in Rochester, New York, implemented a capitation payment system (CPS) for individuals with chronic mental illness.
  • Evaluating such innovative payment models is crucial for understanding their impact on patient care and resource utilization.

Purpose of the Study:

  • To present the methodology for evaluating the effectiveness and impact of the capitation payment system (CPS) on chronic mentally ill patients.
  • To establish a framework for assessing patient outcomes and resource utilization within a demonstration project.

Main Methods:

  • A randomized controlled trial design was employed with 1,587 eligible patients assigned to control or experimental groups.
  • Baseline data on symptomatology, functioning, and resource utilization were collected for a subset of patients contacted for inclusion.

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  • The experimental group was designed to include patients who would eventually enroll in the CPS.

    • Main Results:

    • Baseline data were obtained from 422 of 605 contacted patients (69.7% response rate).
    • The baseline control group comprised 143 patients, while the experimental group included 279 patients.
    • Of the patients in the experimental group, 153 were subsequently enrolled in the capitation payment system (CPS).

    Conclusions:

    • The study established a robust methodology for evaluating capitation payment systems in mental healthcare.
    • The design allowed for patient and provider choice, facilitating enrollment into the CPS.
    • Further analysis is needed to determine the specific outcomes and resource implications of the CPS.