Managed care and ethnic minority populations

Managed care in mental health has changed practice patterns and utilization with largely unknown consequences for ethnic minority populations. Managed care promotes oversight and continuity, but may inadvertently create barriers to access beyond those already apparent under fee-for-service. Capitation rewards efficiency and flexibility but may promote incentives that discourage minority inclusion. As mental health system reform proceeds, the need for culturally informed programs, practices, and practitioners has not diminished. The challenge is to bring cultural expertise to bear within new organizational arrangements and financing schemes.