Download or read book Managing Managed Care written by Institute of Medicine and published by National Academies Press. This book was released on 1997-04-21 with total page 394 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Managing Managed Care written by Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care and published by National Academies Press. This book was released on 1997-05-05 with total page 395 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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.
Download or read book Managed Behavioral Health Care Current Realities and Future Potential written by David Mechanic and published by Jossey-Bass. This book was released on 1998-07-14 with total page 148 pages. Available in PDF, EPUB and Kindle. Book excerpt: Discussions of managed care are dominated by emotion and rhetoric and failure to differentiate among the varying structures, approaches, and strategies that are called managed care. These discussions rarely take account of the complexity of the arena or the failures of mental health systems prior to the introduction of managed care. If we are to shape managed care constructively, we first need clear understanding of how it is structured, how it functions, and when it performs well and poorly. This should help identify how practices can best be monitored, evaluated, and, if necessary, regulated. This book will help readers along this path. This is the 78th issue of the quarterly journal New Directions for Mental Health Services. For more information on the series, please see the Journals and Periodicals section.
Download or read book Preventive Interventions Under Managed Care written by Sharon L. Dorfman and published by . This book was released on 2000 with total page 94 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Managed Behavioral Health Care Handbook written by E. Clarke Ross and published by Jones & Bartlett Learning. This book was released on 2001 with total page 426 pages. Available in PDF, EPUB and Kindle. Book excerpt: Written by a team of nationally recognized authorities on managed care, Managed Behavioral Health Care Handbook guides you through specific strategies that characterize contemporary efforts made at managing behavioral health care, building a clear understanding of their role, and their effect in improving the quality of behavioral health care today, and in the future. From beginning to end, you will learn the core components of the managed behavioral health care process and gain invaluable insight into the numerous controversies and public policy issues.
Download or read book Mental Health Providers Guide To Managed Care written by Leonard Reich and published by W. W. Norton & Company. This book was released on 2006 with total page 252 pages. Available in PDF, EPUB and Kindle. Book excerpt: For both patients and providers, the words managed care are loaded with negative connotations, synonymous with inefficiency and bureaucracy. Forced to perform a delicate balancing act of offering the best possible care for their clients while carefully adhering to various managed care policies and procedures, providers in particular often wince at the prospect of having to deal with managed care companies, or MCOs. Fearing burdensome paperwork, low reimbursement rates, and denials of care, it's not surprising that a number of mental health professionals choose to limit their involvement with managed care companies-or eliminate it altogether. "My clients are all on different health plans; how can I keep the policies straight?" "Getting services approved is so time-consuming that I'm better off accepting only self-paying clients, aren't I?" "Do the benefits of working with MCOs really outweigh the drawbacks?" The answer, according to two industry insiders, is yes. If you know how to work with the system, the system can work for you. Mental Health Provider's Guide to Managed Care is the first handbook of its kind to offer clinicians a window into the inner-workings of MCOs. Authors Reich and Kolbasovsky candidly draw on their combined 37 years experience in the field to walk readers through all the major elements of how to successfully work within the system: marketing yourself and your practice to an MCO, getting onto a MCO's network, maintaining a good relationship and communicating with MCOs for quick service approval, reducing your liability, understanding your rights and responsibilities, getting paid, and more. Every issue—big and small—is covered, from capitation versus fee-for-service payment arrangements to evaluating which MCOs are a good fit to join, and everything in between. After explaining how to work with the system, the authors reveal how to put the system to work for you. Tips for building your practice through referrals, generating business through doctor collaboration, and understanding future practice opportunities are all covered.By demystifying the complexities of managed care and offering a unique, inside view of the process, this book mitigates the negative connotations associated with MCOs and exposes the hidden benefits of a seemingly burdensome process. Exceedingly reader-friendly and packed with insightful tips and vignettes, Mental Health Provider's Guide to Managed Care is one clinician's guide you won't want to be without.
Download or read book The Managed Care Answer Book for Mental Health Professionals written by Gayle McCracken Tuttle and published by Psychology Press. This book was released on 1997 with total page 164 pages. Available in PDF, EPUB and Kindle. Book excerpt: First Published in 1997. Routledge is an imprint of Taylor & Francis, an informa company.
Download or read book The Clinician s Guide to Managed Behavioral Care written by Norman Winegar and published by Psychology Press. This book was released on 1996 with total page 356 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed care is a revolution impacting the practice of clinicians throughout America. The Clinician's Guide to Managed Behavioral Care, called "a survival kit" and "must reading," helps clinicians develop and market professional services attuned to the needs of managed care systems, manage the utilization process, and reshape an office practice or hospital-based program to become more "managed care friendly." It is newly referenced and updated for clinicians to continue to advocate for their patients and clients.The Clinician's Guide to Managed Behavioral Care addresses how clinicians can develop and market professional services attuned to the needs of managed care systems, how to best manage the utilization review process, how to re-shape an office practice or hospital-based program to become more "managed care friendly," and how to best advocate for patients and clients. Readers will understand the history and evolution of attempts to manage mental health care costs and services as well as the emerging clinical, economic, and social trends that will continue to fuel changes in the mental health field in coming years. Importantly, this guide sensitizes readers to the perspectives about mental health care benefits and the treatment field held by the payor community--insurance carriers, HMO's, and self-insured employers. It allows readers to consider a payor's view of how professionals can play a crucial role in providing quality services while helping control spiraling mental health care costs--costs that have escalated much faster than other segments of health care.Who can benefit from this book? Practicing psychologists, social workers, psychiatrists, substance abuse counselors, marriage and family therapists, Employee Assistance Professionals, psychiatric nurses, professional counselors, program managers, hospital administrators, and health care marketing professionals will find The Clinician's Guide to Managed Behavioral Care and invaluable resource.It is often said that in the future, all in the treatment community will be involved in "managing care" and that the most successful clinicians and practices will be those most adept at working with managed care systems on behalf of their patients and clients. This book helps you understand how!Important topics in The Clinician's Guide to Managed Behavioral Care: the changing marketplace for mental health/substance abuse treatment services assessing market opportunities in light of managed care influences clinical service needs of managed care systems clinical innovations: examples, case studies, vignettes strategies for managing utilization review marketing strategies for office-based practitioners hospital-managed care partnerships contemporary office management strategies to control costs consumers and managed care directory of America's HMOs directory of America's Managed Mental Health Care Companies glossary of key terms
Download or read book The Clinician s Guide to Managed Behavioral Care written by William Winston and published by Routledge. This book was released on 2014-02-04 with total page 356 pages. Available in PDF, EPUB and Kindle. Book excerpt: Managed care is a revolution impacting the practice of clinicians throughout America. The Clinician’s Guide to Managed Behavioral Care, called “a survival kit” and “must reading,” helps clinicians develop and market professional services attuned to the needs of managed care systems, manage the utilization process, and reshape an office practice or hospital-based program to become more “managed care friendly.” It is newly referenced and updated for clinicians to continue to advocate for their patients and clients. The Clinician’s Guide to Managed Behavioral Care addresses how clinicians can develop and market professional services attuned to the needs of managed care systems, how to best manage the utilization review process, how to re-shape an office practice or hospital-based program to become more “managed care friendly,” and how to best advocate for patients and clients. Readers will understand the history and evolution of attempts to manage mental health care costs and services as well as the emerging clinical, economic, and social trends that will continue to fuel changes in the mental health field in coming years. Importantly, this guide sensitizes readers to the perspectives about mental health care benefits and the treatment field held by the payor community--insurance carriers, HMO’s, and self-insured employers. It allows readers to consider a payor’s view of how professionals can play a crucial role in providing quality services while helping control spiraling mental health care costs--costs that have escalated much faster than other segments of health care. Who can benefit from this book? Practicing psychologists, social workers, psychiatrists, substance abuse counselors, marriage and family therapists, Employee Assistance Professionals, psychiatric nurses, professional counselors, program managers, hospital administrators, and health care marketing professionals will find The Clinician’s Guide to Managed Behavioral Care and invaluable resource. It is often said that in the future, all in the treatment community will be involved in “managing care” and that the most successful clinicians and practices will be those most adept at working with managed care systems on behalf of their patients and clients. This book helps you understand how! Important topics in The Clinician’s Guide to Managed Behavioral Care: the changing marketplace for mental health/substance abuse treatment services assessing market opportunities in light of managed care influences clinical service needs of managed care systems clinical innovations: examples, case studies, vignettes strategies for managing utilization review marketing strategies for office-based practitioners hospital-managed care partnerships contemporary office management strategies to control costs consumers and managed care directory of America’s HMOs directory of America’s Managed Mental Health Care Companies glossary of key terms
Download or read book Earning a Living Outside of Managed Mental Health Care written by Steven Walfish and published by American Psychological Association (APA). This book was released on 2010 with total page 264 pages. Available in PDF, EPUB and Kindle. Book excerpt: Successful practices outside of managed care result from developing personal passions, creating opportunities. . . and reading this book! Walfish connects the reader not only to real psychologists who have found a variety of niches but also to ready-touse strategies and practical references. You're sure to find several ideas to expand your practice.ùJana N. Martin, PhD, independent practice and Chief Operating Officer of the American Psychological insurance Trust --
Download or read book Concise Guide to Managing Behavioral Health Care Within a Managed Care Environment written by Michael Isaiah Bennett and published by American Psychiatric Pub. This book was released on 2008-08-13 with total page 103 pages. Available in PDF, EPUB and Kindle. Book excerpt: How can behavioral health clinicians provide managed care in an ethical, professionally satisfying way while also dealing with managed care organizations (MCOs)? This concise yet powerful volume will jump-start clinicians in their search for effective answers. Unlike other managed care guides, which tend to view the clinician-managed care relationship as inherently adversarial, this groundbreaking pocket guide (another in American Psychiatric Publishing's Concise Guides series) views resource management as a basic function -- indeed, an ally -- of ethical clinical practice. True managed care both improves the quality of clinical care and protects community resources. It even stimulates patients to become more active managers of their own care. The author, speaking from extensive first-hand experience as both network provider and MCO administrator, asserts that clinicians must know how to manage care themselves to effectively persuade insurance companies to pay for treatment. Toward that end, the author details the practical tools clinicians need in just five chapters: Chapter 1, Managing Care Ethically, discusses basic principles and methods for making clinical decisions about behavioral health care when resources are limited and methods for communicating these decisions to patients and MCOs. Chapter 2, Managing Nonacute Care, applies the principles and methods from Chapter 1 to providing non-acute, usually outpatient, services. Chapter 3, Managing Acute Care, applies the principles and methods from Chapter 1 to providing acute crisis or inpatient services. Chapter 4, Marketing to Managed Care Organizations, details strategies for negotiating contracts to often unreceptive MCOs who consider their networks full, showing how clinicians can enhance their market value by filling MCO needs. Chapter 5, Managing Utilization Review, offers insights on overseeing the clinical work of colleagues and shaping the health care system, assuming that care managers are professionally obligated to help patients receive the care they need and deserve without intruding on the clinician's role, and that the best management manages least, taking responsibility for efficient resource utilization and ongoing system improvement. This practical guide is more than just a handbook for successfully navigating MCO procedures and market dynamics; it also shows that the outcome of truly managed care can be just as satisfying and effective as care provided with infinite resources. Invaluable to clinicians in everyday practice, this remarkable guide with its unique insights, collaborative approach, and case examples will also find a wide audience among clinical administrators in private and public MCOs who train network clinicians and utilization managers.
Download or read book Managed Mental Health Care written by and published by . This book was released on 1996 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Behavioral Managed Care written by M. J. Werthman and published by McGraw-Hill Companies. This book was released on 1997 with total page 192 pages. Available in PDF, EPUB and Kindle. Book excerpt: This study reveals and explains how managed care affects operations from an insider's viewpoint, and exposes the real interaction that occurs among consumers, providers, managed care companies and insurance firms. Topics covered include: goals and limitations of behavioural managed care in treating mental illness and chemical dependency; the role of case management in risk assessments; the utilization review process as it relates to levels of care; case scenarios from intake to treatment completion or treatment continuation; and an examination of the problems consumers and providers face in the provider selection process and how to solve them.
Download or read book The Provision of Mental Health Services in Managed Care Organizations written by and published by . This book was released on 2003 with total page 84 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Integrating Behavioral Health and Primary Care written by Robert E. Feinstein and published by Oxford University Press. This book was released on 2017 with total page 593 pages. Available in PDF, EPUB and Kindle. Book excerpt: Integrated care incorporates behavioral and physical health services into primary care and specialty medical environments. These models of care are patient-centered. population focused, and delivered by a multidisciplinary team of medical professionals. This book is practical, office-based, comfortably accessible, and intended for mental health professionals, primary care and medical specialists, and professional health students, residents, and other professionals working in integrated care environments.
Download or read book A Psychologist s Proactive Guide to Managed Mental Health Care written by Alan J. Kent and published by Routledge. This book was released on 1999-12 with total page 171 pages. Available in PDF, EPUB and Kindle. Book excerpt: A Psychologist's Proactive Guide to Managed Mental Health Care offers a concise overview of the evolution of managed mental health care and its impact on the working lives of clinical and counseling psychologists. Although many books explore the ramifications of managed care for psychotherapy, this is the first to take a broad perspective and examine the ways in which the new health care delivery system is affecting all aspects of practice--not just treatment but also assessment and training--as well as mental health research. The authors include some of the country's most noted psychologists with extensive experience in managed care. Their tone is optimistic rather than pessimistic; as they look at developments others have only deplored, they see potential roles and opportunities for growth for psychologists. In an era of dramatic health change, all those practitioners who are concerned about how to make managed care work for them rather than against them, will find this Guide essential reading. ALTERNATE BLURB A Psychologist's Proactive Guide to Managed Mental Health Care offers a concise overview of the evolution of managed mental health care and its impact on the working lives of clinical and counseling psychologists. While many books explore the ramifications of managed care for psychotherapy, this is the first to take a broad perspective and examine the ways in which the new health care delivery system is affecting all aspects of practice--not just treatment but also assessment and training--and mental health research as well.
Download or read book Managing Managed Care written by Michael C. Roberts and published by Springer Science & Business Media. This book was released on 2012-11-19 with total page 201 pages. Available in PDF, EPUB and Kindle. Book excerpt: The introduction of the concept of managed care into mental and physical health care appears to be a juggernaut of unparalleled impact. The two extremes of thought about this impact are (I) that managed care is a villainous foe to be resisted in order to bring back the earlier halcyon years of independence in practice decisions with greater reimbursement for psychologists' services or (2) that managed care is a laudatory attempt to restrain health care costs that are out of control and spiraling upward by rooting out mismanagement and reversing financial incentives to provide unnecessary care. The former view calls managed health care such names as "mangled care" and distributes bumper stickers stating "Just Say No to HMOs. " The latter view points to the slowdown of increases in health care expenditures and the enhancement of health care affordability and appropriateness for greater numbers of persons resulting from managed care cost-containment strategies and service review procedures. Mental or behavioral health care has been as strongly impacted as medical care under managed care. Where managed care has forced practitioners' attention to validated procedures and to examining previous wasteful practices, we ap plaud the movement. Where managed care has had adverse impact, we think there needs to be greater public, legal, and regulatory attention to its excesses and abuses.
