How mental health providers see managed care

Abstract

This paper reports findings from two focus groups on managed care conducted in a large U.S. city in 1989. Questions addressed included how managed care had affected mental health practice, specific experiences with managed care, the mechanisms of managed care, and how managed care could be improved. The practitioners complained of multiple problems, but clearly distinguished between "good" and "bad" firms. Firms seen as more positive struck a balance between quality care and cost containment, built ongoing relationships with providers, and negotiated with providers, rather than prescribing a treatment plan. The authors conclude that some of the poor reception by providers of managed care may have been created unnecessarily by firms which have not attended to these factors, and that attention to such factors might lead to a more ready acceptance of managed care.

Effects of a clinical feedback system on client and therapist outcomes in a rural community mental health center

“…Providers adapted by carefully choosing the plans they contracted with, learning the language of managed care (which could be considered "gaming the system"), and seeing fewer pro bom patients. Some providers intended to change their practice styles, others intended to leave practice altogether, and still others felt that the situation would change as managed care firms matured and achieved a balance between cost containment and quality of care (Thompson et al, 1991).…”