Skip to main content
Health Services Research logoLink to Health Services Research
. 1990 Oct;25(4):615–625.

The effects of a prepaid group practice on mental health outcomes.

K B Wells 1, W G Manning Jr 1, R B Valdez 1
PMCID: PMC1065648  PMID: 2211130

Abstract

Does a prepaid group practice relative to comparable fee-for-service plans lead to different mental health outcomes for its beneficiaries? To answer this question, we used data from the RAND Health Insurance Experiment. We observed no statistically significant or clinically meaningful differences in mental health outcomes for families randomly assigned to Group Health Cooperative of Puget Sound or to comparable fee-for-service insurance plans in the Seattle area. We found the same null result for overall mental health status as well as for psychological distress (e.g., anxiety and depression) and psychological well-being, and for the full population as well as the initially sick and poor, although our precision was low for the latter comparisons. Thus, the less intensive style of treatment in the prepaid group practice was not associated with noticeably worse mental health outcomes.

Full text

PDF
617

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Brook R. H., Ware J. E., Jr, Davies-Avery A., Stewart A. L., Donald C. A., Rogers W. H., Williams K. N., Johnston S. A. Overview of adult health measures fielded in Rand's health insurance study. Med Care. 1979 Jul;17(7 Suppl):iii-x, 1-131. [PubMed] [Google Scholar]
  2. Diehr P., Williams S. J., Martin D. P., Price K. Ambulatory mental health services utilization in three provider plans. Med Care. 1984 Jan;22(1):1–13. doi: 10.1097/00005650-198401000-00001. [DOI] [PubMed] [Google Scholar]
  3. Ellwood P. M. Shattuck lecture--outcomes management. A technology of patient experience. N Engl J Med. 1988 Jun 9;318(23):1549–1556. doi: 10.1056/NEJM198806093182327. [DOI] [PubMed] [Google Scholar]
  4. Gaus C. R., Cooper S., Hirschman C. G. Contrasts in HMO and fee-for-service performance. Soc Secur Bull. 1976 May;39(5):3–14. [PubMed] [Google Scholar]
  5. Manning W. G., Leibowitz A., Goldberg G. A., Rogers W. H., Newhouse J. P. A controlled trial of the effect of a prepaid group practice on use of services. N Engl J Med. 1984 Jun 7;310(23):1505–1510. doi: 10.1056/NEJM198406073102305. [DOI] [PubMed] [Google Scholar]
  6. Newhouse J. P. A design for a health insurance experiment. Inquiry. 1974 Mar;11(1):5–27. [PubMed] [Google Scholar]
  7. Stewart A. L., Ware J. E., Jr, Brook R. H. Advances in the measurement of functional status: construction of aggregate indexes. Med Care. 1981 May;19(5):473–488. doi: 10.1097/00005650-198105000-00001. [DOI] [PubMed] [Google Scholar]
  8. Valdez R. B., Ware J. E., Jr, Manning W. G., Brook R. H., Rogers W. H., Goldberg G. A., Newhouse J. P. Prepaid group practice effects on the utilization of medical services and health outcomes for children: results from a controlled trial. Pediatrics. 1989 Feb;83(2):168–180. [PubMed] [Google Scholar]
  9. Ware J. E., Jr, Brook R. H., Rogers W. H., Keeler E. B., Davies A. R., Sherbourne C. D., Goldberg G. A., Camp P., Newhouse J. P. Comparison of health outcomes at a health maintenance organisation with those of fee-for-service care. Lancet. 1986 May 3;1(8488):1017–1022. doi: 10.1016/s0140-6736(86)91282-1. [DOI] [PubMed] [Google Scholar]
  10. Ware J. E., Jr, Manning W. G., Jr, Duan N., Wells K. B., Newhouse J. P. Health status and the use of outpatient mental health services. Am Psychol. 1984 Oct;39(10):1090–1100. doi: 10.1037//0003-066x.39.10.1090. [DOI] [PubMed] [Google Scholar]
  11. Wells K. B., Manning W. G., Jr, Benjamin B. Use of outpatient mental health services in HMO and fee-for-service plans: results from a randomized controlled trial. Health Serv Res. 1986 Aug;21(3):453–474. [PMC free article] [PubMed] [Google Scholar]
  12. Wells K. B., Manning W. G., Jr, Valdez R. B. The effects of insurance generosity on the psychological distress and psychological well-being of a general population. Arch Gen Psychiatry. 1989 Apr;46(4):315–320. doi: 10.1001/archpsyc.1989.01810040021004. [DOI] [PubMed] [Google Scholar]
  13. Wells K. B., Stewart A., Hays R. D., Burnam M. A., Rogers W., Daniels M., Berry S., Greenfield S., Ware J. The functioning and well-being of depressed patients. Results from the Medical Outcomes Study. JAMA. 1989 Aug 18;262(7):914–919. [PubMed] [Google Scholar]
  14. Williams S. J., Diehr P., Drucker W. L., Richardson W. C. Mental health services: utilization by low income enrollees in a prepaid group practice plan and in an independent practice plan. Med Care. 1979 Feb;17(2):139–151. doi: 10.1097/00005650-197902000-00004. [DOI] [PubMed] [Google Scholar]

Articles from Health Services Research are provided here courtesy of Health Research & Educational Trust

RESOURCES