Supported employment and managed care: Can they coexist?

Some observers fear that increasing reliance on managed care and capitated payment will reduce access to vocational rehabilitation services particularly bose provided within public mental health systems. However data from two studies suggest that under conditions of fiscal restraint vocational services could actually reduce costs. This article identifies the mechanisms by which costs might be reduced (improved functioning and substitution), examines some preliminary evidence, ann discusses the implications for integrated vocational services under managed care and/or capitated payment systems.