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View from the bridge: Reflections of a recovering staff model HMO psychiatrist

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Abstract

The phenomenon of managed care is misperceived by its critics as a movement. Atheoretical in nature, and driven by spiralling health care costs, it represents the introduction of an executive function into the free-for-all (a supremely ironic term) of American medicine. Part one of this article traces the origin and development of the mental health carve-out, relating it to its antecedents, and describing its 3 overlapping phases: utilization review, discounted fees, and network development and management. Part two describes the key concept of the continuum of care and the role of the case manager in monitoring a care episode. The article concludes by anticipating seven future trends and calling for mental health leadership to recognize and ally with the need to manage resources in a more rational and efficient manner.

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Authors and Affiliations

  1. Harvard Medical School, USA

    Michael J. Bennett M.D. (Eastern Regional Medical Director for American Biodyne, Inc. and Assistant Clinical Professor of Psychiatry)

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  1. Michael J. Bennett M.D.
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Bennett, M.J. View from the bridge: Reflections of a recovering staff model HMO psychiatrist. Psych Quart 64, 45–75 (1993). https://doi.org/10.1007/BF01071838

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