South Philadelphia Health Action (SPHA), the central planning, development, and administrative unit for a prepaid health plan called the Philadelphia Health Plan (PHP), will demonstrate and document the linkages between prepaid group practice medical groups and local federally-funded Community Mental Health Programs. SPHA, a community-based, consumer-dominated corporation, has established PHP to provide prepaid cost-effective, high quality, comprehensive health care in a network of group practices. Five autonomous Medical Groups, operating from seven delivery sites in Center City, South and West Philadelphia, are under contract to PHP to provide health care services to private sector, GAPS, and medical assistance Plan enrollees. The Project will service as a catalyst for the medical groups to develop high quality, cost-effective means for the provision of mental health services; the medical groups are encouraged to work with federally-funded CMHCs, in accordance with SPHA's basic principle of using available, existing community resources. The Project will concentrate on the development and actual operation of the direct service linkages and the non-service interface between these two provider groups. Narrative information, utilization and cost data, and record review information will be used the document to demonstration. Surveys of Plan providers and enrollees will be conducted to determine satisfaction with mental health service delivery mechanisms. As PHP increases its mental health benefits and number of delivery sites, these dimensions will be incorporated into the study. Problems, advantages, and factors involved in the successful operation of the interface will be identified. Key linkage variables will be defined; recommendations as to linkage viability and replication will be made as appropriate. Considerable effort will be made by the project staff in the dissemination of the findings and recommendations of the demonstration to both HMO and federally-funded CMHC program planners and providers.
NIH ExPorter
NIH ExPorter