United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 2000-12-19 monographic deposited born digital 40 p. GA 1.13:GAO-01-224 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-224 P0b002ee18039d8e0 f:d01224 DGPO 2010-08-12 2011-03-23 GAOREPORTS-GAO-01-224 machine generated eng fdlp REPORT GAOREPORTS-GAO-01-224 GAO-01-224 Mental health care services Managed health care State-administered programs Community health services Disadvantaged persons Medicare Program Medicaid Program Letter Report

Between 1987 and 1997, the growth in mental health spending in the United States roughly paralleled the growth in overall health care spending. However, federal mental health spending grew at more than twice the rate of state and local spending. This led to the federal government's share surpassing that of state and local governments, while the share attributable to private sources declined slightly. The ability to care for more people in the community has been facilitated by the continued development of new medications that have fewer side effects and are more effective in helping people manage their illness. Furthermore, treatment approaches such as assertive community treatment, supported employment, and supportive housing have been developed to provide the multiple forms of ongoing assistance that adults with Serious Mental Illness (SMI) often need if they are to function in the community. The Health Care Financing Administration (HCFA) has encouraged the use of community-based services for Medicaid beneficiaries with SMI by disseminating information on the use of new medications and treatment models, which can help people function better in the community. HCFA also supports states' use of Medicaid managed health care services. However, incentives associated with capitated payment can lead to reduced service utilization. HCFA is developing a set of safeguards for people with special health care needs enrolled in Medicaid managed health care and has indicated that it will devise a plan to implement these safeguards, such as through legislative or regulatory action or making changes in Medicaid administrative policies. https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-01-224/html/GAOREPORTS-GAO-01-224.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-GAO-01-224/pdf/GAOREPORTS-GAO-01-224.pdf GAO-01-224 https://www.govinfo.gov/app/details/GAOREPORTS-GAO-01-224 Letter Report GAO-01-224; Mental Health: Community-Based Care Increases for People; Mental health care services Managed health care State-administered programs Community health services Disadvantaged persons Medicare Program Medicaid Program Title 42 Section 1315 Title 42 Section 1395 Title 42 Section 1396n Title 42 Section 1396u Title 42 Section 3796iiet seq. 42 U.S.C. 1315 42 U.S.C. 1395 42 U.S.C. 1396n 42 U.S.C. 1396u 42 U.S.C. 3796iiet seq. Volume 77 Page 290 77 Stat. 290 Volume 89 Page 304 89 Stat. 304 Volume 95 Page 543 95 Stat. 543 Volume 111 Page 251 111 Stat. 251 Volume 114 Page 2399 114 Stat. 2399 Public Law 88-164 Public Law 94-63 Public Law 97-35 Public Law 105-33 Public Law 106-515