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Consumer turnover in service utilization patterns: implications for capitated payment

D Roth1, M B Snapp, B G Lauber

  • 1Office of Program Evaluation and Research, Ohio Department of Mental Health, Columbus 43266-0414, USA.

Administration and Policy in Mental Health
|September 4, 1998
PubMed
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Cluster analysis of service utilization for individuals with severe mental disabilities reveals significant client movement, cautioning against managed healthcare capitation plans based solely on past service use.

Area of Science:

  • Healthcare Management
  • Mental Health Services Research
  • Health Economics

Background:

  • Managed healthcare systems aim to integrate individuals with severe mental disabilities.
  • Risk-adjusted capitation rates are proposed to incentivize this inclusion.
  • Effective risk classification methods for these populations are currently undetermined.

Purpose of the Study:

  • To identify patterns of service utilization among consumers with severe mental disabilities.
  • To evaluate the suitability of cluster analysis for risk stratification in managed care.
  • To inform the implementation of risk-adjusted capitation models.

Main Methods:

  • Cluster analysis was applied to a dataset of 4,346 consumers in Ohio.
  • Service delivery patterns were analyzed to identify distinct client clusters.

Related Experiment Videos

  • Temporal analysis examined client movement between service clusters over time.

    • Main Results:

    • Distinct patterns of service utilization were identified using cluster analysis.
    • Significant client movement into and out of service clusters was observed over time.
    • Past service utilization alone may not be a stable predictor of future needs.

    Conclusions:

    • The dynamic nature of service needs for individuals with severe mental disabilities complicates risk adjustment.
    • Caution is advised when implementing risk-adjusted capitation plans reliant on historical service data.
    • Further research is needed to develop more robust methods for risk classification in mental healthcare.