The Managed Care Answer Book / Edition 1

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Overview

First published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.

Appropriate for: Psychotherapists, Mental Healthcare Professionals.

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Editorial Reviews

Doody's Review Service
Reviewer: Melissa E. Abraham, MS (Northwestern University Feinberg School of Medicine)
Description: This book is an extended question and answer session about issues pertinent to mental health providers who work or will be working in a managed care environment. Topics such as authorization and financing are explained in a manner that is relevant to the day-to-day practice of mental health clinicians.
Purpose: The purpose is to provide a "nuts-and-bolts" resource for psychotherapists about the business of providing services in a managed care setting. Mental health practitioners are frequently frustrated by the complex terminology and logistics of health care delivery in today's environment, and this book was written to clarify the issues most important to mental health clinicians.
Audience: This book is written for all levels of mental health professionals, and is most appropriate for those who are on the service delivery side, rather than more experienced health care administrators. The authors' choice of questions and topics follows from their extensive experience in managed care and behavioral health care delivery.
Features: The book discusses trends occurring in the managed care environment and includes some general predictions about the changes that might develop in the near future. Terminology and implications of managed care concepts such as accountability, decision-making/utilization management, outcomes measurement and monitoring, profiling and credentialing, treatment plans, and authorization are explained in straightforward, lay terms.
Assessment: This book is a useful read for those involved in direct provision of mental health services. The book is organized more as a read-through text rather than a desk-top reference, and is more appropriate for "beginners" in managed care than for better informed behavioral health care administrators. It provides easy-to-read descriptions and practical examples that illustrate how particular features of managed care are relevant to one's own daily practice, and also clarifies some common misconceptions.
Melissa E. Abraham
This book is an extended question and answer session about issues pertinent to mental health providers who work or will be working in a managed care environment. Topics such as authorization and financing are explained in a manner that is relevant to the day-to-day practice of mental health clinicians. The purpose is to provide a "nuts-and-bolts" resource for psychotherapists about the business of providing services in a managed care setting. Mental health practitioners are frequently frustrated by the complex terminology and logistics of health care delivery in today's environment, and this book was written to clarify the issues most important to mental health clinicians. This book is written for all levels of mental health professionals, and is most appropriate for those who are on the service delivery side, rather than more experienced health care administrators. The authors' choice of questions and topics follows from their extensive experience in managed care and behavioral health care delivery. The book discusses trends occurring in the managed care environment and includes some general predictions about the changes that might develop in the near future. Terminology and implications of managed care concepts such as accountability, decision-making/utilization management, outcomes measurement and monitoring, profiling and credentialing, treatment plans, and authorization are explained in straightforward, lay terms. This book is a useful read for those involved in direct provision of mental health services. The book is organized more as a read-through text rather than a desk-top reference, and is more appropriate for "beginners" in managed care than for better informed behavioralhealth care administrators. It provides easy-to-read descriptions and practical examples that illustrate how particular features of managed care are relevant to one's own daily practice, and also clarifies some common misconceptions.

3 Stars from Doody
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Product Details

  • ISBN-13: 9780876308486
  • Publisher: Taylor & Francis
  • Publication date: 8/28/1997
  • Edition description: New Edition
  • Edition number: 1
  • Pages: 128
  • Product dimensions: 7.00 (w) x 9.90 (h) x 0.50 (d)

Table of Contents

Foreword
Ch. 1 Psychotherapy: Cottage to Industry 1
Ch. 2 How It Works: For You, or Against You 23
Ch. 3 The Shapes We're In 58
Ch. 4 The Check Is in the Mail 76
Ch. 5 To Market, To Market 91
Ch. 6 Life After Managed Care 115
App. A. Glossary 125
App. B Provider Guidelines 131
App. C Managed Behavioral Health "Carve-Out" Firms 133
App. D Outcomes Measurement Tools 139
App. E. Sample Forms 141
Bibliography 145
Index 149
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