Managed Care Organizations’ Use of Treatment Management Strategies for Outpatient Mental Health Care
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A nationally representative sample of managed care organizations was surveyed (response rate=92%) regarding use of treatment management techniques for outpatient mental health care in their commercial products in 1999. Bivariate tests and logistic regression models were used to examine the relationship between product type, behavioral health contracting arrangement and treatment management techniques (prior authorization, standards for time to initial appointment, concurrent review, standards for follow-up after discharge, case management, practice guidelines). Prevalence varied from 43% to 87% depending on the technique. HMO products and products with specialty behavioral health contracts were more likely to use the techniques. Product type and contracting arrangement had independent effects.
KEY WORDS:mental health managed care utilization management contracting
- Kemper P., Blumenthal D., Corrigan J. M., Cunningham P. J., Felt S. M., Grossman J. M., Kohn L. T., Metcalf C. E., St. Peter R. F., Strouse R. C., Ginsburg P. B. (1996). The design of the Community Tracking Study: A longitudinal study of health system change and its effects on people. Inquiry 33(2): 195–206PubMedGoogle Scholar
- Kessler R. C., Berglund P., Demler O., Jin R., Koretz D., Merikangas K. R., Rush A. J., Walters E. E., Wang P. S. (2003). The epidemiology of major depressive disorder. Results from the National Comorbidity Survey Replication (NCS-R). Journal of the American Medical Association 289(23): 3095–3105CrossRefPubMedGoogle Scholar
- Shah B. V., Barnwell B. G., Bieler G. S. (1997). SUDAAN User’s Manual: Release 7.5. Research Triangle Park. North Carolina, Research Triangle InstituteGoogle Scholar
- Sturm, R. (1999). Cost and quality trends under managed care: Is there a learning curve in behavioral health carve-out plans? Journal of Health Economics 593–604Google Scholar
- U.S. Dept. of Health and Human Services (USDHHS). (1999). Mental health: A report of the Surgeon General. Rockville, MD: US Dept. of Health and Human Services, Substance Abuse and Mental Health Services Administration, Center for Mental Health Services, National Institutes of HealthGoogle Scholar
- US Health Resources and Services Administration. (2001). “Health work force” [accessed on September 20, 2001]. Available at: http://www.bhpr.hrsa.gov/healthworkforce/toolbox.htm.