The Clinician's Guide to Managed Behavioral Care

Managed care is a revolution impacting the practice of clinicians throughout America. The Clinician's Guide to Managed Behavioral Care, called "a survival kit" and "must reading," helps clinicians develop and market professional services attuned to the needs of managed care systems, manage the utilization process, and reshape an office practice or hospital-based program to become more "managed care friendly." It is newly referenced and updated for clinicians to continue to advocate for their patients and clients.The Clinician's Guide to Managed Behavioral Care addresses how clinicians can develop and market professional services attuned to the needs of managed care systems, how to best manage the utilization review process, how to re-shape an office practice or hospital-based program to become more "managed care friendly," and how to best advocate for patients and clients. Readers will understand the history and evolution of attempts to manage mental health care costs and services as well as the emerging clinical, economic, and social trends that will continue to fuel changes in the mental health field in coming years. Importantly, this guide sensitizes readers to the perspectives about mental health care benefits and the treatment field held by the payor community--insurance carriers, HMO's, and self-insured employers. It allows readers to consider a payor's view of how professionals can play a crucial role in providing quality services while helping control spiraling mental health care costs--costs that have escalated much faster than other segments of health care.Who can benefit from this book? Practicing psychologists, social workers, psychiatrists, substance abuse counselors, marriage and family therapists, Employee Assistance Professionals, psychiatric nurses, professional counselors, program managers, hospital administrators, and health care marketing professionals will find The Clinician's Guide to Managed Behavioral Care and invaluable resource.It is often said that in the future, all in the treatment community will be involved in "managing care" and that the most successful clinicians and practices will be those most adept at working with managed care systems on behalf of their patients and clients. This book helps you understand how!Important topics in The Clinician's Guide to Managed Behavioral Care: - the changing marketplace for mental health/substance abuse treatment services - assessing market opportunities in light of managed care influences - clinical service needs of managed care systems - clinical innovations: examples, case studies, vignettes - strategies for managing utilization review - marketing strategies for office-based practitioners - hospital-managed care partnerships - contemporary office management strategies to control costs - consumers and managed care - directory of America's HMOs - directory of America's Managed Mental Health Care Companies - glossary of key terms

William Winston, Norman Winegar

Contents Introduction - What is "Managed Care"? - Managed Care Basics: Health Maintenance Organizations - Preferred Provider Organizations and Mental Health Point-of-Service Networks - Employee Assistance Programs and Managed Care - Managed Behavioral Care Systems - Contracting with Managed Care - Managing the Utilization Management Process - Legal Issues and Utilization Management - Marketing to Managed Care - Critical Issues - Appendix A: Mental Health Provider Agreement - Appendix B: Directory of America's Health Maintenance Organizations - Appendix C: Treatment Summary - Appendix D: S.O.A.P. Process Note Recording Format - Appendix E: Managed Care Directory, 1995 - Appendix F: Brief Therapy Reading List - Appendix G: Managed Care Market Share Estimates, 1995 - Glossary - Index