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Biomedical subjects

D Y Patterson

Publications and source records attributed to D Y Patterson.

10 recordsLinked to original sources
PubMed1998

Dialogue. Carve-out or HMO: which will serve public sector beneficiaries better?

We are pleased to have three distinguished and thoughtful participants take part in this issue's Dialogue section. As the healthcare industry changes dramatically, new ideas and different approaches are being aired and debated. The three panelists in this discussion attempt to meet head on some of the problems that presently beset managed care and give us their expertise about the pros and cons of privatization, integrated systems, carve-outs, and carve-ins. They provide examples of steps that are being taken right now and suggest alternative means to achieving a more responsive and equitable system. Dr. Patterson provides an overview of the history of this question. Dr. Stelovich argues for systems that integrate mental health and medical services in a managed care setting and suggests that they provide the mental health patient with better healthcare delivery. Deborah Happ makes the case for the carve-out approach in which behavioral health and physical health services are separated and put under the direction of managed behavioral healthcare organizations (MBHOs). She cites Tennessee's TennCare Partners Program as an example of a successful endeavor and carve-out alternative.

Delivery of Health Care, Integrated↗
PubMed1990

Managed care: an approach to rational psychiatric treatment.

The author argues that rational mental health care delivery is possible through an appropriate managed care system of independent providers. The right model for delivery of care incorporates principles that include rational assignment of clinical functions, epidemiologic accountability, fiscal as well as clinical responsibility, open and direct patient access, incentives for preventive psychiatry, partnership between management and clinical providers, choice of services, outcome assessment, and interface between public and private providers. The author maintains that a link between what is good about private practice and what is good in rational managed care represents the best mental health care delivery system currently available.

Managed Care Programs↗
PubMed1982

The future of health maintenance organizations.

Health maintenance organizations, though in existence since about 1940, gained nationwide attention in the early 1970s as an efficient system for delivering health care services. Though initially condemned by organized medicine as unethical, the HMO has today become a rapidly growing health care system, and one, according to the author, vital to the future of the private practice of medicine. The author sketches the history of third-party payers, and the role of the government in health care since the Depression and discusses its effect on private practice. The HMO, fostered by government action under the Nixon administration, is viewed as a pro-competitive wedge that will break the long-standing monopoly held by Blue Cross-Blue Shield, hospitals, and local medical societies. It is through the HMO or an HMO-like model that the future health care system will become more cost-effective, egalitarian, and accessible to those in need of services, the author says.

Cost-Benefit Analysis↗
PubMed1981

A comparison of mental health costs and utilization under three insurance models.

Published reports on utilization and costs of mental health services provided under three insurance models (prepaid, cost-financed and indemnity) reveal consistently greater utilization of outpatient services, lower overall inpatient utilization and comparable costs among prepaid plans in contrast with other two models. The present study suggests that prepaid plans, by facilitating the use of specialty mental health services by a substantially greater proportion of their membership than the other two models, come closer to serving their total population in need as projected by epidemiologic studies. While the data on cost containment are less clear, prepaid plans show a shift in costs away from inpatient and toward outpatient care. However, because of the possibility of bias of differences in population served, treatment philosophy and benefits offered, conclusions drawn from these findings must be tentative until a prospective comparison controlling for these differences can be carried out.

Costs and Cost Analysis↗
PubMed1981

A unique approach to mental health services in an HMO: indemnity benefit and service program.

Three years' experience with a unique combination of an indemnity benefit plus an in-house service program in a prepaid group practice plan's psychiatric department demonstrates enhanced accessibility and increased utilization among formerly unserved segments of the membership plus the flexibility of freedom of choice in choosing service provider and the ability to tailor treatment to patient needs. Overall costs were similar to those reported for other prepaid plans despite the addition of benefits for long-term therapy outside the plan. Flexible use of inpatient and day hospital services enabled the program to migrate, to a large extent, major increases in hospital charges while providing greater continuity of care. This combination of benefits offers the advantages of both an indemnity benefit (Freedom of choice in treatment) and an in-house service program (greater continuity of care, more flexible use of resources, reduction of reliance on hospital care).

Ambulatory Care↗
PubMed1981

Productivity of mental health professionals in a prepaid health plan.

To determine staff productivity in the psychiatry department of a prepaid health plan, the authors compared hours of direct service with professional time available. Psychiatrists exceeded the time standards set, and other staff achieved about three-fourths of the initial standards. The findings provided a basis for refining the standards for each professional discipline. Establishing flexible productivity standards in a system that promotes open discussion and provides continuing positive feedback promotes more efficient scheduling, which can significantly increase service time in the face of limited resources.

Counseling↗
PubMed1975

How to avoid taking the boards but save face.

The author present several options for other psychiatrists who wish to avoid taking board examinations and still save face. Although the author states that none of these worked for him, he wishes to present his suggestions to others in the field.

Certification↗