Case management in psychiatric inpatient recapture

A 2-year reduction of $5.25 million in inpatient costs, representing a decrease of 74%, resulted from implementation of a Psychiatric Management Initiative at Munson Army Community Hospital. Case management was a major component. Management in the military Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) system has major differences from the civilian sector. The military case manager functions as a "guest" in the civilian psychiatric hospitals with no authority to direct care. The practice involves trend analysis, team work, innovative treatment alternatives, and active discharge planning with follow-up. This program was successful in the recapture of CHAMPUS costs despite constraints by CHAMPUS regulations. Costs went from $3,555,285 in fiscal year 1993 down to $600,743 in fiscal year 1995.