Managed mental health care and independent practice: A challenge to psychology.

Abstract

The rapid development of managed mental health care systems has created serious problems for psychology. This article addresses several issues that are inherent in the manner in which psychology responds to the development of these systems, particularly whether effective psychological treatment must be compromised in such systems. One model of managed mental health care is described.By 1992, 70% of the American population might well receive health care through a managed care system (Ginsberg et al., 1985). This growth of managed health care is in response to the need for cost containment-a concept which has become the sine qua non for corporations, unions, and the health industry in a time when the cost of health care approaches 11 % of the gross national product. The urgent need for cost containment in health care has created a new marketplace for enterprising health care entrepreneurs, established insurance companies, and Fortune 500 corporations. The proliferating development of an alphabet soup of managed health care systems (HMOs, PPOs, PPAs, IP As, TPAs, and EPOs) has been in response to the need to contain health care costs. This need to contain costs has also provided an opportunity for entrepreneurs to turn a handsome profit. Managed health care is fast becoming big business.Initially, these new health care organizations were not necessarily concerned with quality of

Realities of mental health practice in managed-care settings.

“…Because their costs have not been viewed as excessive, outpatient costs have been the source of fewer controls. However, some savings have been realized in outpatient care by matching clients with appropriate therapists and interventions (Berkman et al, 1988). This document is copyrighted by the American Psychological Association or one of its allied publishers.…”

“…Information management becomes of critical importance in managed systems (Berkman et al, 1988). Typically, the contracting group needs to know at any time its client load, therapist load, and financial health.…”

Managed Mental Health: A Primer for Counselors

“…High quality of service will be necessary given the competitiveness of the field. As Berkman, Bassos, and Post (1988) pointed out, "the best and most time-tested insurance for the survival of any business is the delivery of high quality product" (p. 437).…”

Professional Licensing and Clinical Practice

“…Already, in San Diego, three major health maintenance organizations (HMOs) care for over 90% of the population who have health insurance (Patterson & Scherger, 1995). Further, the majority of mental health patients may soon be receiving services within managed care settings (Berkman, Bassos, & Post, 1988). Also, solo practice seems to be becoming an increasing rarity (Cummings & Dorken, 1986;Dorken & Curnmings, 1991;Cummings, 1995).…”