Long-term care services for the chronically mentally ill: reimbursement system structure, effects, and alternatives.

Kyle L. Grazier, Dr.P.H. is Assistant Professor in the Department of Social and Administrative Health Sciences, University of California at Berkeley. Comprehensive care for the chronically mentally ill (CMI) in the United States is affected both directly and indirectly by reimbursement mechanisms. Because of the nature of chronic mental illness, the CMI patient receives services traditionally delivered to the long-term care population. Since present payment mechanisms for long-term care focus on the nursing home aged, the CMI patient falls into an inappropriate category. Therefore, alternative delivery and reimbursement models must be devised and policy must be reexamined. This article reviews long-