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Defining managed care in public-sector psychiatry
M A Hoge1, L Davidson, E E Griffith
1Yale University School of Medicine, New Haven, Connecticut 06519.
Hospital & Community Psychiatry
|November 1, 1994
Summary
Public sector managed care is gaining traction due to rising demand and fragmented services. A functional analysis is needed to tailor it effectively, as private models are inadequate for public mental health systems.
Area of Science:
- Public health policy
- Mental health services research
- Health services administration
Background:
- Managed care, established in the private sector, is increasingly explored in public health systems.
- Growing demand, budget constraints, and fragmented care models for serious mental illness drive this interest.
- Existing private sector managed care models are insufficient for public sector needs due to population and delivery differences.
Purpose of the Study:
- To analyze the functions of managed care within the public sector.
- To provide a framework for evaluating public sector managed care systems.
- To assess innovations like privatization and capitation in public mental health care.
Main Methods:
- Conceptual analysis of managed care principles.
- Functional analysis of public sector treatment systems.
- Evaluation of healthcare reform proposals related to managed care.
Main Results:
- No consensus exists on the optimal form or function of public sector managed care.
- Private sector managed care approaches are not directly transferable to the public arena.
- A functional analysis framework is proposed for evaluating public managed care.
Conclusions:
- A tailored, functional approach is essential for implementing managed care in public mental health.
- Understanding system strengths and weaknesses is crucial for effective public managed care.
- Further evaluation is needed for innovations within public managed care systems.