Market-based disparities in foster care service provision

Objective: This study examines in-agency and out-of-agency service provision to a sample of 243 foster children and their families. Method: Data come from a longitudinal study of 243 foster children and families served by non-profit agencies that were operating under either a performance-based, managed care purchase-of-service contract or a fee-for-service reimbursement mechanism. Results: Children and families served by agencies with performance-based, managed care contracts receive fewer of three of five types of services than those served by agencies reimbursed through fee-for-service contracts. Conclusions: Results suggest that performance-based, managed care contracting is related to suppressed service provision and may lead to service disparities between foster children and families served under different market environments.