The organization of mental health care delivery in HMOs

Shadle, Maureen; Christianson, Jon B.

doi:10.1007/bf00818722

Cited by 17 publications

(6 citation statements)

References 8 publications

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“…A major national survey of HMOs and managed care was conducted in 1986 (Shadle & Christianson, 1988). One part of the study examined the growth and changes within individual HMOs and within the managed-care industry.…”

Section: Growth Of Hmos and Managed-care Systemsmentioning

confidence: 99%

“…Three major trends were noted by Shadle and Christianson (1988) about the managed health care industry. First, the mix of organizational structures of HMOs has changed.…”

Section: Growth Of Hmos and Managed-care Systemsmentioning

confidence: 99%

“…The Shadle and Christianson (1988) HMO survey was conducted in the fall of 1986. It provided a useful overview of the nature of mental health services currently provided in managed-care systems.…”

Section: Mental Health Care In Hmosmentioning

confidence: 99%

“…Although the Shadle and Christianson (1988) HMO survey suggested fairly good availability of psychological services in HMOs, the quality of such care has been questioned (cf. Buie, 1989c1, artificial barriers to access to such care has been noted (e.g., Welch, 1986a1, and the exclusion of access to psychologistproviders has been legally challenged (Buie, 1990).…”

Section: Mental Health Care In Hmosmentioning

confidence: 99%

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Managed mental health care: A history of the federal policy initiative.

DeLeon¹,

VandenBos²,

Bulatao³

1994

The Mental Health Professional's Guide to Managed Care.

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The true beginning of the modern concept of managed health care is somewhat obscure. There are events in the early 1900s that could lead one to agree to a date like 1904 or 1906. With the Ross-Loos Clinic becoming operational in 1929, that year has a good claim. The Depression-era efforts of Kaiser Permanente became fully recognized in 1945, so that date stands out. The passage of the federal Health Maintenance Organization Act in 1973 can be viewed as a central date as well.The lumbering and mining industries operating in the Pacific Northwest in the early 1900s provided the site of a n early prepayment plan-that is, the provision of a set package of health care services by a n identified provider for a preestablished fee. The Western Clinic, a fee-for-service partnership in Tacoma, Washington, is reported to be one of the first prepaid group practices. In 1906, two physicians contracted to provide medical care for lumber employees for 5 0 ~ per individual per month. Physicians in private practice in Tacoma, in opposition to the prepaid concept, organized the Pierce County Medical Service Bureau and attempted to limit competition and became a predecessor of county medical societies (Bennett, 1988;Flinn, McMahon, & Collins, 1987).The combination of prepayment schemes with group practice arrangements began in the 1920s. In the rnid-l920s, a prepaid system for farmers in cooperatives in rural Oklahoma was initiated. In 1929, the Ross-Loos Medical Group contracted with the employees of the Los Angeles County Department of Water and Power and their families for a consumer-controlled comprehensive health care program.The Kaiser Permanente Health Plan is another forerunner to the modern health maintenance organization (HMO). The Kaiser Permanente version of managed health care was born in the Mojave Desert of California during the

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Section: Growth Of Hmos and Managed-care Systemsmentioning

confidence: 99%

“…Three major trends were noted by Shadle and Christianson (1988) about the managed health care industry. First, the mix of organizational structures of HMOs has changed.…”

Section: Growth Of Hmos and Managed-care Systemsmentioning

confidence: 99%

Section: Mental Health Care In Hmosmentioning

confidence: 99%

Section: Mental Health Care In Hmosmentioning

confidence: 99%

See 2 more Smart Citations

Managed mental health care: A history of the federal policy initiative.

DeLeon¹,

VandenBos²,

Bulatao³

1994

The Mental Health Professional's Guide to Managed Care.

View full text Add to dashboard Cite

show abstract

“…There are also data about staffing patterns in HMOs. An InterStudy survey revealed that the mean number of psychologists per 10,000 health plan members was 1.61, in comparison with 3.05 psychiatrists and 1.38 psychiatric nurses/social workers (Shadle & Christianson, 1987).…”

mentioning

confidence: 99%

Collaboration in capitated care: Challenges for psychology.

Belar

1995

Professional Psychology: Research and Practice

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This article highlights the mutual dependence of disciplines in capitated care systems, with a focus on a sample program at Kaiser Permanente. Challenges for psychology are discussed as they relate to intradiscipline issues, relationships with other psychosocial care disciplines, and broad health care systems issues. The author suggests that psychology's future in capitated care will rest on skills in research, program development, and specialty practice areas (e.g., clinical health psychology, clinical neuropsychology) and encourages advocacy for the elimination of mind-body dualism in health care policy.There is now little doubt in professional psychology that there have been, and will be, changes in the manner in which health care is delivered in this country. According to the Group Health Association of America National Directory of Health Maintenance Organizations (HMOs) database, the number of people cared for by HMOs has increased fourfold since 1982, reaching 45.2 million members nationwide at year-end 1993. As of March 1994, 556 HMOs were in operation nationwide, nearly double the number available a decade ago. Of these, 40% have been in operation for 10 years or more and account for almost 75% of all HMO members. Consolidation in the industry continues, as mergers or acquisitions involved 20 plans in 1993. In addition, although in 1991 the predominant plan model was the independent practice association (IPA), nearly a quarter of all plans were group or staff model HMOs, and these accounted for almost 40% of all HMO enrollees.' Physician hospital organizations (PHOs) will most likely dominate the piecemeal delivery systems common today, as only such integrated systems are capable of providing the comprehensive, seamless care consumers are demanding. Clearly a sizable proportion of our population will obtain their services from capitated group or staff model health care systems.

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