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Private and public insurance deny few services

Understanding how mental illness cases are managed for insured populations by large managed behavioral health organizations, and comparing the quality of care in large health care systems are the focus of two articles in the May issue of the Psychiatric Services Journal.

Managed behavioral health organizations are now responsible for providing mental health benefits to the majority of privately insured Americans, and have significantly reduced the costs compared with indemnity insurance and HMOs. In a study from the University of California, Davis, researchers examined the process of utilization management and found that after 9,639 reviews, less than 10 percent of treatment services were denied, or were approved at a level lower than requested by the provider.

A study from Connecticut-Massachusetts VA Mental Illness Research, Education, and Clinical Center measured the quality of mental health care of VA hospitals with privately insured patients. Researchers found that although the private sector modestly outperformed the VA on most quality measures, the VA treats a more troubled population, and the VA improved over time compared with the private sector.

1. ["Utilization Management in a Large Managed Behavioral Health Care Organization," by Alan Koike, et. al., pp. 621-626] APAfastFAX#6936 2. ["Comparing Quality of Mental Health Care for Public-Sector and Privately Insured Populations," by Douglas L. Leslie, et. al., pp. 650-655] APAfastFAX#6937

Also in this issue of Psychiatric Services Journal:

Police on Front Line in Mental Health Emergencies

Because police play a critical role in mental health emergencies, communities nationwide have introduced special training and practices to help ensure that people experiencing a mental health crisis are diverted from jails to treatment settings. In a study affiliated with Policy Research Associates in New York, researchers compared programs in three U.S. cities--Memphis, Bi
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Contact: Erin Murphy
emurphy@psych.org
202-682-6324
American Psychiatric Association
26-Apr-2000


Page: 1 2

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