Critical mandates: prevention and health promotion

Health maintenance organizations are supposed to maintain health, not just contain the cost of treating illness. Prevention and health promotion are critical mandates for managed care organizations, including managed behavioral health plans. More often than not, however, health plans have neglected to include prevention and behavioral health promotion services within their spectrum of covered benefits. In this article, the authors explain why there is a growing trend toward including coverage for prevention and promotion services in managed behavioral health plans, including the financial advantages and cost-containment opportunities that result. The article also illustrates several simple and straightforward models for structuring prevention benefits, managing the utilization and quality of prevention services, and including community-based preventive services organizations in provider networks.