Managed care: an approach to rational psychiatric treatment

The author argues that rational mental health care delivery is possible through an appropriate managed care system of independent providers. The right model for delivery of care incorporates principles that include rational assignment of clinical functions, epidemiologic accountability, fiscal as well as clinical responsibility, open and direct patient access, incentives for preventive psychiatry, partnership between management and clinical providers, choice of services, outcome assessment, and interface between public and private providers. The author maintains that a link between what is good about private practice and what is good in rational managed care represents the best mental health care delivery system currently available.