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The Promise and Pitfalls of Purchase-of-Service Contracts
Robert A. Dorwart; Mark Schlesinger; Richard T. Pulice
Psychiatric Services 1986; doi:
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The authors thank Sue Roth and Evelyn Smith Demille for research assistance and staff of the Massachusetts Department of Mental Health for their assistance in obtaining data.

Harvard Medical School (Cambridge Hospital) and the Mental Health Policy Working Group, Harvard University Division of Health Policy Research and Education, John F. Kennedy School of Government, 79 Kennedy Street, Cambridge, Massachusetts 02138

The Center for Health Policy and Management at the Kennedy School of Government

Harvard Medical School

1986 American Psychiatric Association

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Abstract

Dr. Sharfstein's Introduction: A critical issue in the economics of mental health care is how we structure the financing of services and who becomes empowered to deliver those services. The quality and accountability of psychiatric care is thus caught in issues other than the level or degree of support for psychiatric care. The case of purchase-of-service contracting in Massachusetts is an important lesson on the interaction of public and private resources and settings and the pitfalls that can occur when public agencies contract with private vendors to provide mental health services.

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