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Mental health and managed care
1Center for Health Research, Kaiser Permanente, Kaiser/Group Health, Portland, OR 97227, USA. durhamma@chr.mts.kpnw.org
Annual Review of Public Health
|June 5, 1998
Summary
Managed mental health care is widespread but under-researched. Current evidence suggests no negative impact on patient outcomes, despite cost-saving measures and altered treatment approaches.
Area of Science:
- Health Services Research
- Mental Health Policy
- Healthcare Management
Background:
- Managed care is the primary model for mental health service delivery.
- Limited research exists to guide policy in this rapidly growing area.
- Managed care has demonstrated cost reductions through decreased hospital utilization.
Purpose of the Study:
- To review the current state of managed mental health care.
- To identify research gaps and policy implications.
- To highlight areas for future investigation.
Main Methods:
- Literature review of managed mental health care.
- Analysis of cost-saving mechanisms.
- Comparison of treatment modalities and staffing in managed care versus fee-for-service.
Main Results:
- Managed care reduces costs by limiting hospital admissions and length of stay.
- Staffing often involves less specialized professionals, with increased use of group and manualized therapies.
- No definitive evidence indicates worse health outcomes for patients under managed care.
Conclusions:
- Further research is urgently needed on cost, quality, access, satisfaction, and functional outcomes.
- The impact of mental health parity on managed care requires investigation.
- Policy decisions should be informed by robust research on managed mental health care effectiveness.