An Evaluation of Contracts Between Managed Care Organizations and Community Mental Health and Substance Abuse Treatment and Prevention Agencies and Between State Medicaid Agencies and Managed Care Organizations

An Evaluation of Contracts Between Managed Care Organizations and Community Mental Health and Substance Abuse Treatment and Prevention Agencies and Between State Medicaid Agencies and Managed Care Organizations
Author: Sara Rosenbaum
Publisher: DIANE Publishing
Total Pages: 144
Release: 1998-12
Genre:
ISBN: 0788139002

A descriptive examination of: (1) the structure & content of provider network agreements between managed care organizations (MCOs) & community mental health & substance abuse (MH/SA) treatment & prevention agencies, proving an assessment of provider contracts to identify the meaning of these instruments for MH/SA service providers, group purchasers, MCOs, individual consumers, & public policy makers; & 2) service agreements between State Medicaid agencies & MCOs for mental health & substance abuse treatment services, addressing enrollment, benefits & services, duties, & quality assurance.

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.