Financing Mental Health Services

Abstract

This article focuses on federal policies that affect the financing of mental health care services. The need for a delicate balance between controlling the costs of care and assuring access to quality services for those in need is addressed. The programs discussed are Medicare, the federal insurance program for the elderly and disabled, and the Civilian Health and Medical Program of the Uniformed Services (CHAMPUS), the Department of Defense program for military dependents and retirees. Efforts to control the costs of care often result in the policy decision to limit significantly the scope of practice of nonphysician health care providers when compared to that authorized by state-level practice and licensing laws. Some federal initiatives that focus on these combined concerns will be discussed including the CHAMPUS initiatives to contract out for services and Medicare's prospective payment system now used for hospital services.