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The promise and pitfalls of purchase-of-service contracts.

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.