Biomedical subjects
Publications and source records attributed to R Geraty.
In this article, the authors review current organized efforts, strategies, and partnerships involved in attempts to design a behavioral health care report card that offers a comprehensive approach to obtaining performance measurements in the fields of psychiatry and chemical dependence treatment.
There has been a dramatic increase in the number of inpatient child and adolescent psychiatric inpatient beds within the past 5 to 10 years. Child psychiatrists have not been trained to play a leadership role in the development and management of these units. Important issues facing the administrative child psychiatrist include the role of the medical director, the development of the clinical program, staffing of the inpatient unit, the design of the physical plant, financing of inpatient care, promotion of the services, and relationship with medical staff.
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Building on a study of the costs of behavioral healthcare under managed care first released in the March/April, 1994 issue of this journal, the American Managed Behavioral Healthcare Association has now turned its attention to two other fundamental issues in healthcare reform: access and quality. The following study presents data indicating how managed behavioral healthcare plans assure quality and access in such areas as response time, accreditation, provider credentialing, patient satisfaction and outcomes measurement.
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As Congress debates the Health Security Act, a key issue centers on whether and how to include mental health and substance abuse benefits and how to contain costs if and when these benefits are paid at parity with general healthcare. Previous studies estimating the average annual cost of providing behavioral healthcare services have shown considerable divergence, depending on the nature of the defined population and the inclusion of various benefit categories, out-of-pocket expense and administrative costs. Experience from 14 members of the American Managed Behavioral Healthcare Association (AMBHA) is used to define the key features of managed behavioral healthcare, and to demonstrate that a properly managed behavioral healthcare benefit can be significantly less costly than the current reform debate would admit. AMBHA companies (which have many years of experience and presently manage the cost and quality of care for over 65 million people in the United States) [See Table 3, page 28], have shown that a specialty managed care approach can achieve not only significant savings to healthcare providers, payers and society, but also improve quality and access to care. Traditional attempts at reducing mental illness benefit coverage costs have entailed limitations on the availability or access to care. These approaches, however, ignored the larger implications to society of untreated mental illness and chemical dependency. When traditional coverages have offered more extensive benefits, they have primarily favored inpatient treatment, thus increasing costs by overemphasizing care of patients at expensive inpatient settings. AMBHA's proposed principles of healthcare reform and recommended benefit packages for behavioral healthcare can be found on page 80 of this magazine.