Capitating mental health services
Article Abstract:
One medical cost control method employers use is separating contracts for mental health care from other health care contracts. Under such contracts, mental health services are capitated under the mainstream or the carve-out method. Carve outs occur because the typical managed care organization lacks the clinical capacity for comprehensive mental health services. The private sector reports significant savings with this cost control method and many states have started funding Medicare and Medicaid this way in hopes of the same result.
Publication Name: Nursing Management
Subject: Health
ISSN: 0744-6314
Year: 1996
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Report cards can improve choice
Article Abstract:
Report cards are being developed to assist consumers in selecting managed care plans. There is little consensus over what measures should be included, how they are presented, and how the information should be disseminated. Benchmarks or norms should be included, and the figures should be adjusted for risk. In addition, the report cards do not provide information on specific clinics or practitioners within a plan or how specific diseases are managed by a given plan. Comparable information is not available for fee-for-service plans.
Publication Name: Nursing Management
Subject: Health
ISSN: 0744-6314
Year: 1997
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Medicare marketing guidelines for managed care
Article Abstract:
Health maintenance organizations (HMOs) are responsible for providing information to members about Medicare that meets standards set by the Health Care Financing Administration (HCFA). Guidelines from HCFA are available to ensure marketing materials are clear, with enough information to help Medicare beneficiaries make informed decisions about choosing health care plans.
Publication Name: Nursing Management
Subject: Health
ISSN: 0744-6314
Year: 1997
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