Understanding managed behavioral health care
| Autor: | Michael A. Hoge, Neil M. Thakur, Selby Jacobs |
|---|---|
| Rok vydání: | 2000 |
| Předmět: |
Gerontology
business.industry Process (engineering) Substance-Related Disorders Mental Disorders Public sector Managed Care Programs Legislature Public relations Mental health United States Psychiatry and Mental health Behavior Therapy Premise Health care Medicine Managed care Humans Confidentiality business Forecasting |
| Zdroj: | The Psychiatric clinics of North America. 23(2) |
| ISSN: | 0193-953X |
| Popis: | Managed care is neither a well-defined concept nor a discrete entity. That which we think of as managed care consists of a broad range of strategies for organizing, financing, and delivering mental health and substance abuse services. Each strategy, as it is implemented, is shaped by the host environment and influenced by local history, politics, laws, and regulations. Thus, managed care emerges with many different functions and in an infinite array of forms. Managed care may constitute sweeping, large-scale change that completely reorganizes the delivery of health care, or it may be as minor as adding some utilization-management strategies within a single provider organization. At times, managed care may be a highly visible public sector initiative in which the contracting process and review of performance and outcomes is subject to consumer, provider, and legislative oversight. Alternatively, it may be an arrangement between an employer and managed care organization (MCO) in which the contracts and data on outcomes remain proprietary and confidential. In an attempt to comprehend this major force, consumers and providers tend to oversimplify. Many condemn managed care, viewing it narrowly as an unethical attempt to cuts costs by denying needed services. Those with an opposing perspective are at times equally narrow in their view that managed care is the solution to the many purported ills of traditional services. Consumers and providers most often try to understand and define managed care by example, citing that which was implemented in a specific state or by a specific employer. These are limited views and approaches to understanding managed care and its many complexities. The purpose of this article is twofold. First the origins of managed care are traced, placing it in historical perspective. Then, an approach to examining specific managed care initiatives, to understand better their core structures, processes, and effects, is outlined. A case example that highlights the utility of this approach is included. The authors' premise is that understanding a specific managed care initiative is best accomplished by examining it on 10 dimensions. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|