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Transferring psychiatric patients into managed care networks
1Network Services, TAO, Inc., Philadelphia, Pennsylvania.
Summary
Selective contracting by managed care organizations frequently transfers psychiatric patients. Physician reluctance to transfer patients stems from treatment disruption and clinical concerns, though transit injury risks appear minimal.
Area of Science:
- Psychiatry
- Health Services Research
- Managed Care
Background:
- Managed care organizations (MCOs) utilize selective contracting, impacting psychiatric patient care pathways.
- Exclusion from provider networks leads to frequent patient transfers from emergency rooms and hospitals.
Observation:
- Physicians not in provider networks may resist transferring psychiatric patients to unfamiliar settings.
- Reasons for resistance include treatment continuity, patient safety during transport, and clinical stabilization needs.
Findings:
- Fears of patient self-injury or harm to others during transit seem unfounded.
- Clinical and risk management considerations remain pertinent for MCOs regarding patient transfers.
Implications:
- MCOs need to address physician concerns to facilitate smoother psychiatric patient transfers.
- Further research on optimizing transfer protocols and risk management in psychiatric care is warranted.