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Casebook for Managing Managed Care: A Self-Study Guide for Treatment Planning, Documentation, and Communication / Edition 1

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Overview

In today's environment of managed care, practitioners face more daunting challenges than ever: treatment authorizations are becoming more difficult to obtain, as are referrals to other healthcare practitioners, which are increasingly performance based.

Into this competitive environment comes Casebook for Managing Managed Care: A Self-Study Guide for Treatment Planning, Documentation, and Communication. Dedicated to helping mental healthcare practitioners clearly articulate and prove the value of what they provide patients within the managed care system, this foundational text uniquely fills a gap in the literature by providing a user-friendly, self-contained tutorial for the Patient Impairment Profile (PIP) documentation method. The PIP combines impairment terminology, the impairment profile, and the various treatment plan components to create a common language for describing behavior-based patient dysfunction and communicating the clinical rationale for treatment.

As a model for treatment plan development, the PIP system trains the practitioner (or treatment team) in the "must-have" skills needed for todays managed care environment. Here practitioners will find explicit instructions about how to • Communicate treatment needs convincingly• Distinguish effectively between goals, objectives, and interventions• Track progress over time• Document treatment summaries efficiently

Using clear language and a wide array of case vignettes, the Casebook demonstrates how using PIPS can streamline the documentation, communication, and decision-making processes.

The Casebook continues the groundbreaking tradition of its predecessors: Managing Managed Care: The Mental Health Practitioner's Survival Guide (Goodman et al. 1992) and Managing Managed Care II: A Handbook for Mental Health Professionals, Second Edition (Goodman et al. 1996). It is uniquely valuable both as a stand-alone instructional text and as a companion to the second edition, which introduced the Patient Impairment Lexicon and the PIP system itself. The Casebook's updates to the Impairment Lexicon definitions that first appeared in Managing Managed Care II are based on the authors' ongoing psychometric evaluation and research.

This practical text will find its way onto the bookshelves of mental healthcare practitioners and managed care personnel alike. Psychiatrists, clinical psychologists, clinical social workers, marriage and family therapists, and psychiatric nurses — especially those participating as managed care providers — and case managers and utilization reviewers within managed care organizations, regardless of background, will find a framework for success within these pages. The Casebook's broad appeal also extends to both students in healthcare disciplines and the graduate programs that train them, and to psychiatric/behavioral healthcare organizations and facilities (inpatient, outpatient, and residential), where it will be used for treatment planning.

American Psychiatric Publishing

The book contains no figures.

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Editorial Reviews

Doody's Review Service
Reviewer: John K. Larson, MD (Rush University Medical Center)
Description: This large, soft-cover book is a follow-up and companion to two previous volumes by Dr. Goodman, Managing Managed Care: A Mental Health Practitioner's Survival Guide (1992), andManaging Managed Care II: A Handbook for Mental Health Professionals, 2nd Edition (American Psychiatric Press, 1996).
Purpose: This volume is intended to be a practical workbook to guide providers in the use of the Patient Impairment Profile (PIP) system in treatment planning and to aid in communication with managed care case managers and reviewers.
Audience: The primary audience includes psychotherapists at all levels of experience who work with clients who have managed mental health benefits. Psychiatric residents and other psychotherapy trainees will also find it an extremely useful introduction to a pragmatic system of assessment and treatment planning.
Features: The book is based on Dr. Goodman's PIP system. The development of PIP arose out of a perceived need to communicate more effectively with managed care reviewers and ensure that patients and clients receive authorization for appropriate care. The system requires identification of specific impairments, a rating of each impairment's severity, treatment goals, patient objectives, specific interventions, and a discharge plan. Ongoing documentation is focused on assessment of progress using patient statements and actions. This volume contains twenty case vignettes for analysis and practice using the terminology of the PIP system. In nine chapters such topics as identifying impairments, rating severity, selecting interventions, and tracking patient progress are covered. Numerous useful tips on communicating patient needs to a third-party reviewer are sprinkled throughout.
Assessment: This volume is an extremely successful exploration of the practical application of the PIP system. It is intended as a "how to" guide and readers who desire a more thorough exploration may want to read one of the other treatises listed above.
John K. Larson
This large, soft-cover book is a follow-up and companion to two previous volumes by Dr. Goodman, Managing Managed Care: A Mental Health Practitioner's Survival Guide (1992), andManaging Managed Care II: A Handbook for Mental Health Professionals, 2nd Edition (American Psychiatric Press, 1996). This volume is intended to be a practical workbook to guide providers in the use of the Patient Impairment Profile (PIP) system in treatment planning and to aid in communication with managed care case managers and reviewers. The primary audience includes psychotherapists at all levels of experience who work with clients who have managed mental health benefits. Psychiatric residents and other psychotherapy trainees will also find it an extremely useful introduction to a pragmatic system of assessment and treatment planning. The book is based on Dr. Goodman's PIP system. The development of PIP arose out of a perceived need to communicate more effectively with managed care reviewers and ensure that patients and clients receive authorization for appropriate care. The system requires identification of specific impairments, a rating of each impairment's severity, treatment goals, patient objectives, specific interventions, and a discharge plan. Ongoing documentation is focused on assessment of progress using patient statements and actions. This volume contains twenty case vignettes for analysis and practice using the terminology of the PIP system. In nine chapters such topics as identifying impairments, rating severity, selecting interventions, and tracking patient progress are covered. Numerous useful tips on communicating patient needs to a third-party reviewer aresprinkled throughout. This volume is an extremely successful exploration of the practical application of the PIP system. It is intended as a "how to" guide and readers who desire a more thorough exploration may want to read one of the other treatises listed above.

3 Stars from Doody
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Product Details

  • ISBN-13: 9780880487832
  • Publisher: American Psychiatric Publishing, Incorporated
  • Publication date: 2/28/2000
  • Format: Spiral Bound
  • Edition description: SPIRAL
  • Edition number: 1
  • Pages: 276
  • Product dimensions: 8.50 (w) x 11.00 (h) x 0.80 (d)

Meet the Author

Jeffrey P. Bjorck, Ph.D., is an Associate Professor of Psychology at Fuller Theological Seminary's Graduate School of Psychology in Pasadena, California. He is also a licensed clinical psychologist in private practice. Dr. Bjorck obtained his Doctor of Philosophy degree from the University of Delaware, having completed his internship at the University of Oklahoma Health Sciences Center. He has served on the faculty of Fuller Seminary's Graduate School of Psychology for the past 9 years, where his teaching responsibilities include courses in Psychometric Theory, MCMI-III Assessment, Human Learning, and Multimodal Therapy. Dr. Bjorck also conducts empirical research, including the ongoing psychometric evaluation of the Patient Impairment Lexicon, which provides the basis for the Patient Impairment Profile system outlined in this text and its companion, Managing Managed Care II: A Handbook for Mental Health Professionals (Goodman, et al. 1996).

Janet A. Brown, R.N., C.P.H.Q., is a consultant in quality, utilization, and risk management with psychiatric and medical-surgical, acute and ambulatory, healthcare organizations, all of which are now positioning for managed care. Ms. Brown has 22 years of experience in the evaluation, development, and implementation of effective strategies, systems, and processes to meet federal and state regulations, accreditation standards, and review requirements, as well as managed care and employer/payer information needs. Ms. Brown is the author of The Healthcare Quality Handbook: A Professionals Resource and Study Guide, currently in its 14th edition, and serves as instructor for quality management professionals preparing for the certification examination. She has chaired the national Healthcare Quality Educational Foundation and was the 1995—1996 president of the National Association for Healthcare Quality.

Michael Goodman, M.D. (1945—1996), was a clinical psychiatrist in private practice in Beverly Hills and Pasadena, California. He attended Tufts Medical School and completed his psychiatry residency at Northwestern University in Chicago, Illinois. Dr. Goodman served for 14 years as a physician advisor with the former California Professional Standards Review Organization and its current successor, California Medical Review, Inc. He was also a consultant in managed mental healthcare with treatment programs and practitioner groups participating in newer managed deliver models. Dr. Goodman was an assistant professor at the UCLA School of Medicine, Department of Psychiatry and Neurobehavioral Sciences, Los Angeles, California. He was also a mental healthcare consultant for the American Medical Association's Doctors Advisory Network, which provides "hands-on" assistance with managed care to members of the American Medical Association. He died on June 17, 1996.

American Psychiatric Publishing

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Table of Contents

Introduction. The impairment inventory: identifying impairments. The impairment inventory: rating impairment severity. The Patient Impairment Profile. Goals and objectives: performance measures for managed care. The treatment plan: selecting interventions. Tracking patient progress. The discharge summary: documenting treatment course. Epilogue. Appendix. Index.

American Psychiatric Publishing

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