Essock S M, Goldman H H
Connecticut Department of Mental Health, USA.
Health Aff (Millwood). 1995 Fall;14(3):34-44; discussion 45-9. doi: 10.1377/hlthaff.14.3.34.
Historically, state mental health authorities have dominated public mental health services, operating with fixed resources and responsible for a large population. A good public mental health system has many of the attributes of a well-managed private mental health system. Unfortunately, public systems are not flexible enough to contract creatively with multiple providers; they lack many of the tools of modern managed care. As a consequence, state mental health authorities have begun to contract with private managed care firms to assist them in managing their health care reform efforts, particularly reform of Medicaid. This paper examines the forces shaping managed behavioral health care in the public sector and describes strategies for managing care, such as contracting, utilization review, and monitoring.
从历史上看，州精神卫生当局主导着公共精神卫生服务，在固定资源下运作并负责大量人口。一个良好的公共精神卫生系统具有许多管理完善的私立精神卫生系统的特征。不幸的是，公共系统不够灵活，无法与多个供应商进行创造性的签约；它们缺乏现代管理式医疗的许多工具。因此，州精神卫生当局已开始与私立管理式医疗公司签约，以协助他们管理医疗改革工作，特别是医疗补助计划的改革。本文探讨了影响公共部门管理式行为健康护理的各种力量，并描述了管理护理的策略，如签约、利用审查和监测。
