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保护公众利益:管理式行为健康护理合同中的问题

Protecting the public interests: issues in contracting managed behavioral health.

作者信息

Robinson Julia E, Clay Thomas

机构信息

University of Colorado, Colorado Springs, USA.

出版信息

J Health Hum Serv Adm. 2003 Spring;25(4):452-70.

Abstract

In recent years, state governments have begun contracting out behavioral health care to large managed case for-profit organizations. This approach to mental health service delivery has resulted in realignment in roles for both state agencies and the managed care organizations. Overnight state agencies have been transformed into contract managers of multi-million dollar capitated health plans, Management care companies, in turn, moving into the public-sector market must adjust their service delivery to include key concepts of public interest involvement such as consumer input, public comment, and outreach. This article analyzes three public-sector transitions. Common issues in these transformations are used as a springboard for identifying key concerns which states need to monitor when developing managed care contracts.

摘要

近年来,州政府已开始将行为健康护理外包给大型营利性管理式医疗组织。这种精神健康服务提供方式导致了州政府机构和管理式医疗组织角色的重新调整。一夜之间,州政府机构已转变为价值数百万美元的按人头付费健康计划的合同管理者,而管理式医疗公司进入公共部门市场后,必须调整其服务提供方式,纳入诸如消费者意见、公众评论和宣传等公共利益参与的关键概念。本文分析了三个公共部门的转型。这些转型中的常见问题被用作一个跳板,以确定各州在制定管理式医疗合同时需要监测的关键问题。

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