Psychiatric managed care at a rural MEDDAC

Area of Science:

• Healthcare Management
• Mental Health Services
• Military Healthcare Systems

Background:

• Rising mental health expenditures at General Leonard Wood Army Community Hospital (GLWACH) presented a significant financial challenge.
• In 1990, mental health services accounted for $2.7 million, representing 58% of the total CHAMPUS costs within the hospital's service area.

Purpose of the Study:

• To evaluate the effectiveness of the Gateway to Care initiative in controlling mental health costs and enhancing care access.
• To assess the impact of coordinated managed care on healthcare expenditures and beneficiary services at GLWACH.

Main Methods:

• Initiation of the Gateway to Care program, a coordinated managed care plan.
• Implementation of five key changes within GLWACH's mental health services framework.
• Focus on expanding outpatient care services to mitigate inpatient admissions.

Main Results:

• CHAMPUS net costs for mental health services decreased to $1.4 million in the first year of the project.
• The initiative successfully provided more comprehensive care to beneficiaries.
• Significant cost reduction was achieved through a strategic shift towards increased outpatient care.

Conclusions:

• The Gateway to Care coordinated managed care model proved effective in reducing military healthcare costs.
• Expanding outpatient mental health services is a viable strategy for controlling overall mental health expenditures.
• The project demonstrated successful cost containment while improving the comprehensiveness of mental health care delivery.