Who will pay for involuntary civil commitment under capitated managed care?
An emerging dilemma. Psychiatric Services, 46(10), 1045-1048. With mental health reimbursement increasingly relying on capitation and managed care principles, there are incentives to limit hospital bed use for the civilly committed. Yet these individuals must often remain hospitalized for even longer periods because of their civil pro-file and the perceived risk involved in releasing them into general society. In this paper, the author explores this conflict as well as the relationship between civil commitment and cost-shifting in a capitated payment system. The author suggests six strategies for providers deal-ing with these issues: avoiding negotiations concerning payment questions after evaluation and treatment have begun by including conditions for civil commitment in their contracts; creating services and social supports to reduce the need for commitment; implementing consistent risk assessment standards for all patients; conducting research on the use of civil commitment in manag
