The psychotherapist and the managed care setting.

This study represents a beginning effort to understand how alternative health care delivery systems affect psychotherapists and psychotherapy practice style. Professionals from various mental health disciplines employed in staff-model health maintenance organizations (N?=?43) served as interviewees. Therapists answered objective and semistructured questions about their work setting, "burn-out," graduate training, and the evolution of self and practice style. Although methodological limitations prohibit meaningful and valid generalizations, the results suggest that alternative health care settings may serve as catalysts by creating an atmosphere that shapes and influences the therapist to develop more eclectic, short-term, problem-focused psychotherapy practice habits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The primary care physician and managed care

I have explored the major options open to PCPs. There are multiple variations on these themes. While the Connecticut market is fluid, one thing is clear, the solutions will vary from place to place. Health-care reorganization is a local phenomenon. Individual doctor groups can have a major influence on the direction of their local market. The future is uncertain, but whatever happens in Connecticut it will be evolutionary. PCPs must understand the realities of the current marketplace and plan a strategy to work with those realities to achieve their long-term goals. The choices we make today will have ramifications flowing far into future decades. PCPs and their patients will have to live with the consequences of these decisions. Please choose wisely.     

Hidden benefits of managed care.

It seems to me we spend so much time complaining about managed care that we never get to talk about managed care's hidden benefits. I call them hidden for just that reason: They are never spoken of, written about, or even mentioned in passing. I have been guilty of that one-sidedness, and so it seemed only fair that I take the opportunity to correct the imbalance. Consequently, I will present here four of the hidden benefits of managed care: (a) technical assistance and education, (b) opportunities for socializing, (c) the promotion of interdisciplinary collaboration, and (d) free supervision. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The "frisson" benefits of managed care.

Comments on the article by Anonymous (see record 1995-33982-001) which, in presenting the hidden benefits of managed care, offers a spoof on the managed care debate. The current author applauds the article for its comic relief and its way of turning the qualities of managed care that are generally considered intrusive into positive attributes. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The managed care movement and the future of psychotherapy.

Examines the effects of managed health care (MHC) on the practice of psychotherapy. MHC has led to new models for intervention that fit the clients' needs within the context of their environment rather than interpreting client behavior to fit a model. Characteristics of MHC psychotherapy include a goal-directed, problem-solving orientation; efficient use of time; outpatient orientation; egalitarian distribution of services; conscious collaboration in the therapeutic alliance; the use of group, self-help, and community resources; and cost effectiveness and high quality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology's response to managed care.

Managed care has had a significant impact on the field of psychology. In this article, a former president of the American Psychological Association and an early career psychologist discuss how managed care has affected the practice of psychology, the training of psychologists, and the perception of psychotherapy. They also review how organized psychology has responded to managed care and provide some insights on the future of psychology as it relates to managed care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Legal liability and managed care.

In attempts to reduce the cost of mental health treatment, health insurers are turning to mechanisms for intensive oversight that fall under the rubric of managed care. These approaches have implications for the potential liability of clinicians and managed care entities. Clinicians may be confronted with legal duties to appeal adverse decisions, to disclose the impact of managed care on patients' treatment, and in some circumstances, to continue treatment after payment has been denied. Managed care entities are being held to duties to conduct review in a reasonable fashion, and may also have a duty to disclose the limitations managed care may place on patients' access to treatment, and to select appropriate providers of care. The law in this area is in an early stage of development and is likely to be refined. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The sentinel effect in an outpatient managed care setting.

Psychologists who provide services under managed care must typically cope with session restrictions and time-consuming paperwork to justify session use. This process has been broadly challenged by critics of managed care. This study investigated the effect of allocating sessions in outpatient treatment on session use. Providers were authorized either 6, 10, or 19 sessions (benefit maximum), with additional sessions given without restriction. Results showed that doctoral-level psychologists in the 6-session, 10-session, and 19-session groups used up to 2.5 sessions more than the control group, whereas master's-level providers used up to 5.5 sessions more. Master's-level providers also had an 18% treatment dropout rate, compared with 7% for psychologists. On the basis of cost analysis, session management is financially warranted for master's-level providers but not for doctoral-level psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction: Psychology's view of managed care.

This introduction to the series of surveys on psychologist reactions to managed care presents an overview of the topics, findings, and conclusions of these surveys done through the American Psychological Association's Practice Directorate, Division 42, and the New Jersey Psychological Association. The results of these studies give a meaningful base for references to psychologist attitudes and reactions to the force of managed care on the profession. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The hospital nurse's role in managed care

This article describes the staff nurse's role in managed care and can be used by nurse managers in the education process. An obstetric case study demonstrates the potential of increasing patient-care quality while reducing health care cost.     

The market for occupational medicine managed care

The metamorphosis of the health care market has opened a window of opportunity for occupational medicine programs and practices to assume a critical role in the delivery of managed occupational and personal health care services. This chapter offers practical suggestions and tips.     

The importance of professional psychology: A view from managed care.

Over the past 15 years, the development of managed health care has led to changes in the way that psychology is practiced and in the ways that quality is measured in the health care system. In this article, the current status of population-based Health Plan Employer Data and Information Set quality metrics are reviewed. Many medical measures of quality have improved in the past 5 years, whereas behavioral health measures have shown only modest improvement. Reasons for this finding are discussed, and it is suggested that quality of care for individuals and populations could improve as psychology adopts evidenced-based practice and clinical practice guidelines. (PsycINFO Database Record (c) 2010 APA, all rights reserved)