Managing Managed Care: Quality Improvement in Behavioral Health

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Overview

Managed care has produced dramatic changes in the treatment of mental health and substance abuse problems, known as behavioral health. Managing Managed Care offers an urgently needed assessment of managed care for behavioral health and a framework for purchasing, delivering, and ensuring the quality of behavioral health care. It presents the first objective analysis of the powerful multimillion-dollar accreditation industry and the key accrediting organizations.
Managing Managed Care draws evidence-based conclusions about the effectiveness of behavioral health treatments and makes recommendations that address consumer protections, quality improvements, structure and financing, roles of public and private participants, inclusion of special populations, and ethical issues.
The volume discusses trends in managed behavioral health care, highlighting the emerging role of the purchaser. The committee explores problems of overlap and fragmentation in the delivery of behavioral health care and discusses the issue of access, a special concern when private systems are restricted and public systems overburdened.
Highly applicable to the larger health care system, this volume will be of particular interest to all stakeholders in behavioral health--federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.

The book contains black-and-white illustrations.

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Editorial Reviews

Doody's Review Service
Reviewer: John K. Larson, MD (Rush University Medical Center)
Description: This is a comprehensive report of the work of the Institute of Medicine's Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Care. The committee solicited input from more than 150 representatives of national accreditation groups, national professional associations, consumer and advocacy groups, managed care industry groups, and federal and state agencies. The book contains in-depth discussions of current trends, challenges, structures and processes, access issues, ethical considerations, outcomes, and concludes with findings and recommendations. It contains numerous tables and appendixes.
Purpose: The purpose is to identify and address the challenges presented by the current state of affairs in managed mental health care, particularly with regard to standards of care and accreditation issues.
Audience: The intended audience consists of mental health providers, health plan administrators, and policymakers at every level.
Features: The book begins with an excellent summary that can serve as an excellent overview and review (or "Cliff Notes" for the lazy reader), followed by eight well-organized chapters, a glossary, and appendixes containing two excellent commissioned papers on outcomes that are worth the price of the book alone. Tables, quotes, and figures sprinkled liberally throughout provide additional clarity and impact.
Assessment: The book is remarkably consistent in organization and tone considering its scope and the diversity of its editors. Most practicing clinicians will recognize the value of the discussions about trends in managed care and outcome measurement. Specific accreditation issues will be of greater interest to clinicians with administrative responsibilities or a special interest in the forces that shape the healthcare environment. The volume should be required reading for administrators of health systems that provide mental healthcare and healthcare policymakers. It is uniformly excellent and appropriately provocative.
Booknews
A report produced by the Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care assessing quality issues and recommending accreditation guidelines. The report underscores the distinction between the structure of behavioral health care delivery and the nature of substance abuse and mental health disorders, drawing evidentiary conclusions on treatment, consumer protections, financing, the roles of public and private participants, special population inclusion, and ethical issues. Annotation c. by Book News, Inc., Portland, Or.

5 Stars! from Doody
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Product Details

  • ISBN-13: 9780309056427
  • Publisher: National Academies Press
  • Publication date: 4/23/1997
  • Edition description: New Edition
  • Pages: 396
  • Product dimensions: 6.48 (w) x 9.00 (h) x 0.34 (d)

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