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S_Wilkes Dissertation Final Draft 2.pdf (1.46 MB)

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THE APPLICATION OF MANAGED CARE TO THE DELIVERY OF CHILD WELFARE SERVICES: AN ANALYSIS OF THE CUYAHOGA COUNTY DEPARTMENT OF CHILDREN AND FAMILY SERVICES’ CASE RATE PILOT PROJECT

Wilkes, Scott A
http://rave.ohiolink.edu/etdc/view?acc_num=case1374834154

Abstract Details

2013, Doctor of Philosophy, Case Western Reserve University, Social Welfare.
In FY 2000, the Cuyahoga County Department of Children and Family Services (CCDCFS) had more than 5,500 children in out-of-home care. In response, CCDCFS implemented a privatized managed care case rate pilot project (CRPP) to test whether managed care principles could improve child welfare outcomes. This study is a child welfare analysis and program evaluation of the CRPP using administrative data. Ordinary least squares and logistic regression models were used to examine the effects of the covariates while two-way ANOVA was used to measure differences between each of the program models. The study examined the effects of demographic (race, gender, age), family (placement reason, number of siblings, geo-district), service (placement proximity, number of placement moves) and organizational (private “managed care” model, public “business as usual” model) characteristics on foster care length-of-stay and exit rates among 114 children enrolled in the CRPP between January 2001 and December 2003. Financial, administrative and management structures distinguished each program model. Agency A, the public control group, was managed as a business-as-usual group using fee-for-service contracts. Agency B, a private managed care group, utilized a strict utilization management model, while Agency C, a private managed care group, employed a community-based model. Each private group was managed by a capitated case rate contract. The study proposed supplier inducement demand theory as a theoretical framework to account for variances with respect to the financial structures. The results of the study revealed that children experiencing additional placement moves or placed in distant proximity from their homes were more likely to have longer lengths-of-stay and lower exit rates in care. The program evaluation revealed that Agency B consistently had lower lengths-of-stay and higher exit rates than the other two groups. The findings of this study suggest the application of managed care in the delivery of child welfare services was not a predictor of child welfare outcomes, but may have promise in lowering costs associated with out-of-home care and improving child welfare outcomes. Child demographic and family characteristics were not predictors of child welfare outcomes as indicated by previous literature; however, service characteristics did impact outcomes.
Crampton David, Dr. (Committee Chair)
Groza Victor , Dr. (Committee Member)
Tracy Elizabeth , Dr. (Committee Member)
Susan Case, Dr. (Committee Member)
209 p.
Social Work
Child welfare; managed care; foster care; case rate; performance contracting; funding; nonprofit organizations; supplier inducement demand theory; permanency; reunification; adoption

Recommended Citations

Citations

  • Wilkes, S. A. (2013). THE APPLICATION OF MANAGED CARE TO THE DELIVERY OF CHILD WELFARE SERVICES: AN ANALYSIS OF THE CUYAHOGA COUNTY DEPARTMENT OF CHILDREN AND FAMILY SERVICES’ CASE RATE PILOT PROJECT [Doctoral dissertation, Case Western Reserve University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=case1374834154

    APA Style (7th edition)

  • Wilkes, Scott. THE APPLICATION OF MANAGED CARE TO THE DELIVERY OF CHILD WELFARE SERVICES: AN ANALYSIS OF THE CUYAHOGA COUNTY DEPARTMENT OF CHILDREN AND FAMILY SERVICES’ CASE RATE PILOT PROJECT. 2013. Case Western Reserve University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=case1374834154.

    MLA Style (8th edition)

  • Wilkes, Scott. "THE APPLICATION OF MANAGED CARE TO THE DELIVERY OF CHILD WELFARE SERVICES: AN ANALYSIS OF THE CUYAHOGA COUNTY DEPARTMENT OF CHILDREN AND FAMILY SERVICES’ CASE RATE PILOT PROJECT." Doctoral dissertation, Case Western Reserve University, 2013. http://rave.ohiolink.edu/etdc/view?acc_num=case1374834154

    Chicago Manual of Style (17th edition)

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© 2013, all rights reserved.
This open access ETD is published by Case Western Reserve University School of Graduate Studies and OhioLINK.