The successful application of medical offset in program planning and in clinical delivery.

Medical cost offset was discovered in the health maintenance organization (HMO) setting over 35 years ago and was used not only to justify the earliest instances of the inclusion of mental health treatment as a benefit, but also was used in program design and development. With the new emphasis on outcomes research, medical cost offset remains a viable method of conducting nonintrusive studies of efficacy, efficiency, and quality. Through the use of the research design described, an early HMO delivery system developed 68 focused, target behavioral interventions that years later became the basis for emerging managed mental health care.