Managing Managed Care


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 II


Book Description

Managing Managed Care II: A Handbook for Mental Health Professionals, Second Edition, provides an easy-to-learn, easy-to-use method for documenting and communicating the necessity, appropriateness, and course of treatment for managed care review. Using the Patient Impairment Profile method, practitioners can convincingly convey a clinical rationale for treatment, efficiently track progress over time, and demonstrate favorable patient outcomes. Keeping pace with the evolving and expanding presence of managed care, the authors have extensively revised and enlarged the previous edition. New clinical research on the validity and reliability of the impairment terminology has produced a much-improved, clinically valid, and statistically reliable impairment lexicon. Detailed severity rating qualifiers, reference lists of patient objectives, and a useful glossary have been added. All regulations have also been updated. Managing Managed Care II is reference and valuable resource for mental health practitioners and for the individuals who monitor and review treatment. By providing concise, relevant, and outcome-focused treatment information, practitioners become proactive participants in managed care while adeptly articulating the value and quality of their services.




Earning a Living Outside of Managed Mental Health Care


Book Description

Successful practices outside of managed care result from developing personal passions, creating opportunities. . . and reading this book! Walfish connects the reader not only to real psychologists who have found a variety of niches but also to ready-touse strategies and practical references. You're sure to find several ideas to expand your practice.ùJana N. Martin, PhD, independent practice and Chief Operating Officer of the American Psychological insurance Trust --




Foundations of Behavioral Health


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.




Handbook of Private Practice


Book Description

Handbook of Private Practice is the premier resource for mental health clinicians, covering all aspects of developing and maintaining a successful private practice. Written for graduate students considering the career path of private practice, professionals wanting to transition into private practice, and current private practitioners who want to improve their practice, this book combines the overarching concepts needed to take a mental health practice (whether solo or in a group) from inception, through its lifespan. From envisioning your practice, to accounting and bookkeeping, hiring staff, managing the practice, and running the business of the practice, a diverse group of expert authors describe the practical considerations and steps to take to enhance your success. Chapters cover marketing, dealing with insurance and managed care, and how to choose your advisors. Ethics and risk management are integrated throughout the text with a special section also devoted to these issues and strategies. The last section features 26 niche practices in which expert practitioners describe their special area of practice and discuss important issues and aspects of their specialty practice. These areas include assessment and evaluation, specialized psychotherapy services, working with unique populations of clients, and more. Whether read cover-to-cover or used as a reference to repeatedly come back to when a question or challenge arises, this book is full of practical guidance directly geared to psychologists, counselors, social workers, and marriage and family therapists in independent practice.




Primary Care


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.




Managed Mental Health Care in the Public Sector


Book Description

The rapid spread of managed care into public and community mental health systems is creating a dramatic transformation of traditional public sector settings. This radical change is affecting administrators, managers, and clinicians.Intended as a survival manual, this book begins with an overview of the history, concepts, ideology, and ethics of public sector managed care and then proceeds in focus from system to program management to clinical program levels. With a concluding section on advocacy, evaluation, research, and training issues, Managed Mental Health Care in the Public Sector examines how public sector managed mental health care can be approached with a positive spirit, an excitement about the potential to create dramatic and beneficial system changes, and a genuine interest in investigating the relative merits of every aspect of managed care systems.




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


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.




Care Without Coverage


Book Description

Many Americans believe that people who lack health insurance somehow get the care they really need. Care Without Coverage examines the real consequences for adults who lack health insurance. The study presents findings in the areas of prevention and screening, cancer, chronic illness, hospital-based care, and general health status. The committee looked at the consequences of being uninsured for people suffering from cancer, diabetes, HIV infection and AIDS, heart and kidney disease, mental illness, traumatic injuries, and heart attacks. It focused on the roughly 30 million-one in seven-working-age Americans without health insurance. This group does not include the population over 65 that is covered by Medicare or the nearly 10 million children who are uninsured in this country. The main findings of the report are that working-age Americans without health insurance are more likely to receive too little medical care and receive it too late; be sicker and die sooner; and receive poorer care when they are in the hospital, even for acute situations like a motor vehicle crash.




Managed Care in Human Services


Book Description

The unique contribution of this book is its exclusive focus on the current impact of managed care on social service organisations and delivery systems, public sector systems, and professional practice. It is one of the only books to address managed care from a social work perspective. And it is the first to address the impact of managed care on services to children.