Hoeksema B J, Coddington D C
Psychiatr Hosp. 1993 Winter-Spring;24(1-2):25-7.
While most of the recent national attention on healthcare reform has focused on physicians, acute-care hospitals, and the insurance industry, what about mental healthcare providers? Where do psychiatric hospitals, psychiatrists, psychologists, and other mental healthcare professionals fit into the healthcare payment system of the future? For example, if the United States ends up with what is called universal access--a payment source for all Americans--will it include mental health benefits? The stakes are high; one quarter of the American population either has no health insurance or is covered by Medicaid. Many current reform proposals include tort reform; but how would it affect mental healthcare providers? Will managed care--primarily health maintenance organizations (HMOs) and preferred provider organizations (PPOs)--be a part of the reshaping of the United States healthcare system? This article has three objectives: To summarize the various healthcare reform proposals and provide a description of the key elements anticipated in the most likely reform package. To consider the strategic implications of payment reform for the mental healthcare industry. To identify strategies for mental healthcare providers that are likely to be useful regardless of the shape of healthcare reform.
尽管近期全国对医疗改革的关注大多集中在医生、急症医院和保险业，但精神卫生保健提供者的情况如何呢？精神病医院、精神科医生、心理学家及其他精神卫生保健专业人员在未来的医疗支付体系中处于什么位置？例如，如果美国最终实现所谓的全民医保——为所有美国人提供支付来源——其中会包括心理健康福利吗？风险很大；四分之一的美国人口要么没有医疗保险，要么由医疗补助计划承保。当前许多改革提议都包括侵权法改革；但这会如何影响精神卫生保健提供者呢？管理式医疗——主要是健康维护组织（HMO）和优先提供者组织（PPO）——会成为美国医疗体系重塑的一部分吗？本文有三个目标：总结各种医疗改革提议，并描述最有可能的改革方案中预期的关键要素。思考支付改革对精神卫生保健行业的战略影响。确定无论医疗改革形式如何都可能有用的精神卫生保健提供者策略。
