Volume 72 Number 4, 1994
Managing Competition in Public and Private Mental Health Agencies: Implications for Services and Policy
Robin E. Clark, Robert A. Dorwart, and Sherrie S. Epstein
The merits of public versus private health care agencies have been vigorously debated, particularly as states ncreasingly contract with community mental health agencies to serve people who need care. Management practices and performance in 452 public and private community mental health agencies in 49 states were examined to ascertain the impact of ownership on an agency's response to competitive pressures. Significant differences emerged in the use of management practices by public and private agencies to maximize efficiency and revenue, but not in measures of public orientation, such as provision of subsidized care. Competition from private practioners increased the use of some management practices in both public and private agenies, but instituting management practices to increase efficiency and revenue did not affect the degree of public service. Ownership alone seems to predict management process better than it does public service orientation.
