Psychiatric managed care at a rural MEDDAC.

Mental health costs at General Leonard Wood Army Community Hospital (GLWACH) have risen every year. In 1990, $2.7 million had been spent on CHAMPUS mental health costs, 58% of the entire CHAMPUS costs for the hospital's catchment area. Gateway to Care, a plan of coordinated managed care conceived by Health Services Command, was initiated at GLWACH to give the commander and providers more flexibility to control costs and improve access to care. Five major changes were made under GLWACH's mental health coordinated care project. In the first full year of the project, CHAMPUS net costs were reduced to $1.4 million while more comprehensive care was provided to beneficiaries. Cost reduction came primarily from dramatically increasing the size and scope of outpatient care to reduce inpatient admissions.