A new approach to managed care: The provider-run organization

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Behavioral managed care has been dominated by for-profit carve-out managed care organizations who deliver mental health and substance abuse services by reducing services and fees to the detriment of patients and providers. We offer a new model of managed care based on a provider-run, hospital-based approach in which provider groups contract directly with HMOs and eliminate the managed care organization intermediaries. This approach allows providers to maintain or regain control of the delivery of behavioral health services. A model is presented of an academically based organization which has achieved utilization patterns compatible with the demands of payors. Innovations in service delivery, network management and fiscal issues are reviewed.

Original languageEnglish (US)
Pages (from-to)345-353
Number of pages9
JournalPsychiatric Quarterly
Volume69
Issue number4
DOIs
StatePublished - 1998

Fingerprint

Managed Care Programs
Organizations
Fee-for-Service Plans
Health Maintenance Organizations
Health Services
Substance-Related Disorders
Mental Health

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

A new approach to managed care : The provider-run organization. / Schwartz, Bruce J.; Wetzler, Scott.

In: Psychiatric Quarterly, Vol. 69, No. 4, 1998, p. 345-353.

Research output: Contribution to journalArticle

@article{5165696778a24ef3a7a6fd14b4e5c87f,
title = "A new approach to managed care: The provider-run organization",
abstract = "Behavioral managed care has been dominated by for-profit carve-out managed care organizations who deliver mental health and substance abuse services by reducing services and fees to the detriment of patients and providers. We offer a new model of managed care based on a provider-run, hospital-based approach in which provider groups contract directly with HMOs and eliminate the managed care organization intermediaries. This approach allows providers to maintain or regain control of the delivery of behavioral health services. A model is presented of an academically based organization which has achieved utilization patterns compatible with the demands of payors. Innovations in service delivery, network management and fiscal issues are reviewed.",
author = "Schwartz, {Bruce J.} and Scott Wetzler",
year = "1998",
doi = "10.1023/A:1022186215834",
language = "English (US)",
volume = "69",
pages = "345--353",
journal = "Psychiatric Quarterly",
issn = "0033-2720",
publisher = "Kluwer Academic/Human Sciences Press Inc.",
number = "4",

}

TY - JOUR

T1 - A new approach to managed care

T2 - The provider-run organization

AU - Schwartz, Bruce J.

AU - Wetzler, Scott

PY - 1998

Y1 - 1998

N2 - Behavioral managed care has been dominated by for-profit carve-out managed care organizations who deliver mental health and substance abuse services by reducing services and fees to the detriment of patients and providers. We offer a new model of managed care based on a provider-run, hospital-based approach in which provider groups contract directly with HMOs and eliminate the managed care organization intermediaries. This approach allows providers to maintain or regain control of the delivery of behavioral health services. A model is presented of an academically based organization which has achieved utilization patterns compatible with the demands of payors. Innovations in service delivery, network management and fiscal issues are reviewed.

AB - Behavioral managed care has been dominated by for-profit carve-out managed care organizations who deliver mental health and substance abuse services by reducing services and fees to the detriment of patients and providers. We offer a new model of managed care based on a provider-run, hospital-based approach in which provider groups contract directly with HMOs and eliminate the managed care organization intermediaries. This approach allows providers to maintain or regain control of the delivery of behavioral health services. A model is presented of an academically based organization which has achieved utilization patterns compatible with the demands of payors. Innovations in service delivery, network management and fiscal issues are reviewed.

UR - http://www.scopus.com/inward/record.url?scp=0031689115&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031689115&partnerID=8YFLogxK

U2 - 10.1023/A:1022186215834

DO - 10.1023/A:1022186215834

M3 - Article

C2 - 9793111

AN - SCOPUS:0031689115

VL - 69

SP - 345

EP - 353

JO - Psychiatric Quarterly

JF - Psychiatric Quarterly

SN - 0033-2720

IS - 4

ER -