Psychiatric service options within a health maintenance organization.

The authors describe a prepaid mental health program affiliated with a Phoenix-based health maintenance organization. Challenged by the need to limit financial risk and by high outpatient utilization rates, this prepaid health plan, developed a policy of service delivery which could both satisfy patient and consultee demands and conserve costs. Staff philosophies, services, administrative characteristics and client population are described. Key concepts in the delivery of service are outlined. The authors conclude by reviewing some of the ethical and financial dilemmas confronting the prepaid mental health professional.