Contracting for Managed Substance Abuse and Mental Health Services

Contracting for Managed Substance Abuse and Mental Health Services
Author: Stephen Moss
Publisher: DIANE Publishing
Total Pages: 318
Release: 2000-09
Genre:
ISBN: 0756702577

In recent years, State Medicaid agencies and other public sector entities -- in particular, State, county, and local substance abuse and mental health (SA&MH) authorities -- have increasingly been taking the initiative to purchase SA&MH managed care (MC) services from private sector org's. or specialized nonprofit agencies. This is a practical guide for public purchasers and others involved in the design and develop. of MC initiatives involving SA&MH services. Chapters: designing, procuring, and implementing a MC system; coverage; contracting for network services; the mgmt. info. system; quality mgmt.; financial issues; and consumer protections. Bibliography.

Managing Managed Care

Managing Managed Care
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 394
Release: 1997-04-21
Genre: Medical
ISBN: 0309175054

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 healthâ€"federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.

Improving the Quality of Health Care for Mental and Substance-Use Conditions

Improving the Quality of Health Care for Mental and Substance-Use Conditions
Author: Institute of Medicine
Publisher: National Academies Press
Total Pages: 528
Release: 2006-03-29
Genre: Medical
ISBN: 0309133661

Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.