The challenges posed by managed behavioral health care
Article Abstract:
Managed mental health care companies and mental health care providers must work together to develop new methods of practice that meet the particular challenges posed by managed care. These challenges affect medical ethics, the definition of mental illnesses, the management of limited resources, and accountability of providers. Managed care defines and treats mental illness in terms of the ability of a person to function, while traditional mental health care is concerned with long-term treatment of underlying illnesses. Mental health care is becoming geared towards the needs of larger populations rather than those of individual patients in one-on-one settings. Managed care is also causing psychiatrists to see more severely ill patients. Fees tend based on the complexity of illness rather than on the training of the provider. Finally, managed care permits case managers, often with less training than providers, to evaluate the quality of care. This arrangement may be replaced by large provider groups that assume financial risk and manage their own care.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1996
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How large employers are shaping the health care marketplace
Article Abstract:
Direct contracting for health care services is one method some large employers have adopted to control the cost of providing health insurance to their employees. In this model, employers join regional purchasing groups to directly contract for services from hospitals and physicians, bypassing insurance companies. Buyers Health Care Action Group in Minnesota developed the Choice Plus plan, covering 125,000 workers. Although innovative, doctors have complained that the bureaucracy remains and that rates are too low. Separating insurance from employment may be a better long-term solution.
Publication Name: The New England Journal of Medicine
Subject: Health
ISSN: 0028-4793
Year: 1998
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