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Biomedical subjects

J Krizay

Publications and source records attributed to J Krizay.

7 recordsLinked to original sources
PubMed1985

Utilization and coverage of mental health services in health maintenance organizations.

Health maintenance organizations (HMOs) generally have very limited coverage of mental health care and have been charged with shortchanging chronic patients in the interests of economy. The authors analyzed 1979-1980 coverage and utilization data from 53 federally qualified HMOs. They found that while coverage is limited and very similar across the spectrum of HMOs, utilization rates vary greatly and do not correlate with extent of coverage. They suggest that management decisions may be critical in determining access to and use of mental health benefits in HMOs.

Ambulatory Care↗
PubMed1982

Federal Employees' experience as a guide to the cost of insuring psychiatric services in the various states.

The two largest plans in the Federal Employees Health Benefits Program-Blue Cross and Blue Shield and Aetna - have reported benefit payments and the number of people who have used psychiatric services on a state-by-state basis for two decades. The author translates this experience into per capita utilization rates in a constant dollar terms and compares the benefit costs of the two plants over a 4-year period (1976-1979). Within each state, utilization rates did not change much over the 4 years, and the rank ordering among states by rate of utilization was quite similar for both plants. The author believes that the consistency noted can be useful in estimating costs of psychiatric coverage at the state level.

Blue Cross Blue Shield Insurance Plans↗
PubMed1980

Measuring psychiatric utilization: the rubber yardstick.

The author suggests that measuring utilization of benefits for nervous and mental disorders by using the percent of total benefits paid is imprecise because even small changes in the much larger portion of benefit payments that are attributable to nonpsychiatric services can make it appear that the level of psychiatric utilization has changed. His preferred measure is a calculation of covered charges attributable to psychiatric care per each person covered under the plan. The author illustrates his points by showing that, when properly calculated, psychiatric utilization under the Civilian Health and Medical Program of the Uniformed Services is much lower than that under many other plans.

Humans↗