Funding of correctional health care and its implications

Abstract Correctional health care is funded through a range of mechanisms, reflecting many of the community fee-for-service and managed care parallels. Like community health care, utilization of health care in correctional settings is increasing. It is, however, often under more significant budgetary constraints and tighter management. The funding of correctional health care is a complex enterprise, driven by constitutionally mandated care obligations on the one hand and resource constraints on the other. The costs of care are quite substantial, and the diversity of models of care delivery offers an administrative challenge, a financial challenge to the relevant jurisdiction, and a significant opportunity for cost effectiveness. Unfortunately, as of yet, no comparative study of funding models has been done. As integrated electronic health and financial records are introduced into correctional settings, opportunities for such studies, and the policy guidance provided by those results, may yield important information applicable to health care cost and outcome management in society more broadly. This chapter includes a discussion of global capitation, per-incarcerated-person costs, at-risk contracting, liability concerns, performance indicators, and a variety of contractual relationships.