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Managing Managed Care

Managing Managed Care PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309175054
Category : Medical
Languages : en
Pages : 394

Book Description
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.

Managing Managed Care

Managing Managed Care PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309175054
Category : Medical
Languages : en
Pages : 394

Book Description
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.

Primary Care

Primary Care PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309175690
Category : Medical
Languages : en
Pages : 411

Book Description
Ask for a definition of primary care, and you are likely to hear as many answers as there are health care professionals in your survey. Primary Care fills this gap with a detailed definition already adopted by professional organizations and praised at recent conferences. This volume makes recommendations for improving primary care, building its organization, financing, infrastructure, and knowledge baseâ€"as well as developing a way of thinking and acting for primary care clinicians. Are there enough primary care doctors? Are they merely gatekeepers? Is the traditional relationship between patient and doctor outmoded? The committee draws conclusions about these and other controversies in a comprehensive and up-to-date discussion that covers: The scope of primary care. Its philosophical underpinnings. Its value to the patient and the community. Its impact on cost, access, and quality. This volume discusses the needs of special populations, the role of the capitation method of payment, and more. Recommendations are offered for achieving a more multidisciplinary education for primary care clinicians. Research priorities are identified. Primary Care provides a forward-thinking view of primary care as it should be practiced in the new integrated health care delivery systemsâ€"important to health care clinicians and those who train and employ them, policymakers at all levels, health care managers, payers, and interested individuals.

Foundations of Behavioral Health

Foundations of Behavioral Health PDF Author: Bruce Lubotsky Levin
Publisher: Springer
ISBN: 3030184358
Category : Psychology
Languages : en
Pages : 398

Book Description
This comprehensive book examines the organization, financing, delivery, and outcomes of behavioral health (i.e., alcohol, drug abuse, and mental health) services from both U.S. and global perspectives. Addressing the need for more integrative and collaborative approaches in public health and behavioral health initiatives, the book covers the fundamental issues in behavioral health, including epidemiology, insurance and financing, health inequities, implementation sciences, lifespan issues, cultural responsiveness, and policy. Featuring insightful research from scholars in an interdisciplinary range of academic and professional fields, chapters fall into three distinct sections: Overview: Outlines the defining characteristics of behavioral health services and identifies significant challenges in the field At-Risk Populations: Explores critical issues for at-risk populations in need of behavioral health services, including children in school environments, youth in juvenile justice systems, and persons with developmental disabilities, among others Services Delivery: Presents a rationale for greater integration of health and behavioral health services, and contextualizes this explanation within global trends in behavioral health policy, systems, and services An in-depth textbook for graduate students studying public health, behavioral health, social work policy, and medical sociology, as well as a useful reference for behavioral health professionals and policy makers, Foundations of Behavioral Health provides a global perspective for practice and policy in behavioral health. It promotes better understanding of the importance of integrating population health and behavioral health services, with an eye towards improving and sustaining public health and behavioral health from national, regional, and global perspectives.

Improving the Quality of Health Care for Mental and Substance-Use Conditions

Improving the Quality of Health Care for Mental and Substance-Use Conditions PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309133661
Category : Medical
Languages : en
Pages : 528

Book Description
Each year, more than 33 million Americans receive health care for mental or substance-use conditions, or both. Together, mental and substance-use illnesses are the leading cause of death and disability for women, the highest for men ages 15-44, and the second highest for all men. Effective treatments exist, but services are frequently fragmented and, as with general health care, there are barriers that prevent many from receiving these treatments as designed or at all. The consequences of this are seriousâ€"for these individuals and their families; their employers and the workforce; for the nation's economy; as well as the education, welfare, and justice systems. Improving the Quality of Health Care for Mental and Substance-Use Conditions examines the distinctive characteristics of health care for mental and substance-use conditions, including payment, benefit coverage, and regulatory issues, as well as health care organization and delivery issues. This new volume in the Quality Chasm series puts forth an agenda for improving the quality of this care based on this analysis. Patients and their families, primary health care providers, specialty mental health and substance-use treatment providers, health care organizations, health plans, purchasers of group health care, and all involved in health care for mental and substanceâ€"use conditions will benefit from this guide to achieving better care.

The Future of the Public's Health in the 21st Century

The Future of the Public's Health in the 21st Century PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309133181
Category : Medical
Languages : en
Pages : 536

Book Description
The anthrax incidents following the 9/11 terrorist attacks put the spotlight on the nation's public health agencies, placing it under an unprecedented scrutiny that added new dimensions to the complex issues considered in this report. The Future of the Public's Health in the 21st Century reaffirms the vision of Healthy People 2010, and outlines a systems approach to assuring the nation's health in practice, research, and policy. This approach focuses on joining the unique resources and perspectives of diverse sectors and entities and challenges these groups to work in a concerted, strategic way to promote and protect the public's health. Focusing on diverse partnerships as the framework for public health, the book discusses: The need for a shift from an individual to a population-based approach in practice, research, policy, and community engagement. The status of the governmental public health infrastructure and what needs to be improved, including its interface with the health care delivery system. The roles nongovernment actors, such as academia, business, local communities and the media can play in creating a healthy nation. Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists.

Common Mental Health Disorders

Common Mental Health Disorders PDF Author: National Collaborating Centre for Mental Health (Great Britain)
Publisher: RCPsych Publications
ISBN: 9781908020314
Category : Health services accessibility
Languages : en
Pages : 316

Book Description
Bringing together treatment and referral advice from existing guidelines, this text aims to improve access to services and recognition of common mental health disorders in adults and provide advice on the principles that need to be adopted to develop appropriate referral and local care pathways.

America's Health Care Safety Net

America's Health Care Safety Net PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 030906497X
Category : Medical
Languages : en
Pages : 304

Book Description
America's Health Care Safety Net explains how competition and cost issues in today's health care marketplace are posing major challenges to continued access to care for America's poor and uninsured. At a time when policymakers and providers are urgently seeking guidance, the committee recommends concrete strategies for maintaining the viability of the safety netâ€"with innovative approaches to building public attention, developing better tools for tracking the problem, and designing effective interventions. This book examines the health care safety net from the perspectives of key providers and the populations they serve, including: Components of the safety netâ€"public hospitals, community clinics, local health departments, and federal and state programs. Mounting pressures on the systemâ€"rising numbers of uninsured patients, decline in Medicaid eligibility due to welfare reform, increasing health care access barriers for minority and immigrant populations, and more. Specific consequences for providers and their patients from the competitive, managed care environmentâ€"detailing the evolution and impact of Medicaid managed care. Key issues highlighted in four populationsâ€"children with special needs, people with serious mental illness, people with HIV/AIDS, and the homeless.

Outreach in Community Mental Health Care

Outreach in Community Mental Health Care PDF Author: Tom Burns
Publisher: Oxford University Press
ISBN: 019875423X
Category : Medical
Languages : en
Pages : 401

Book Description
Outreach in the community is the treatment of choice for the severely mentally ill in the community. It involves taking services directly to patients rather than requiring them to attend clinics and hospitals. This approach is a significant addition to routine mental health care practice and addresses the needs of marginalized communities and those that struggle to attend appointments. Outreach in Community Mental Health Care: A Manual for Practitioners has been fully updated since the last edition, providing readers with an in-depth, practical guide to mental health care in the community setting today. It addresses the significant changes in mental health service organizations over the years, including the various new teams devised and the importance of central planning and targets. The authors Tom Burns and Mike Firn are pioneers in this field of research and are active in community outreach as practitioners, researchers, and supervisors. In 29 chapters they cover key discussions in conceptual issues, health and social care practice, management and development, which provides readers with an insight into the reality of community outreach work.

Homelessness, Health, and Human Needs

Homelessness, Health, and Human Needs PDF Author: Institute of Medicine
Publisher: National Academies Press
ISBN: 0309038324
Category : Medical
Languages : en
Pages : 257

Book Description
There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.

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 PDF Author: Sara Rosenbaum
Publisher: DIANE Publishing
ISBN: 0788139002
Category :
Languages : en
Pages : 144

Book Description
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.