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Substance Abuse and Mental Health Services Administration
Public Sector Moves Managed Care to Forefront of Behavioral Health Services: Tracking and Monitoring Managed Behavioral Healthcare in the Public Sector
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This report provides preliminary information about state managed behavioral health care programs as part of a system to monitor and track such programs in the public sector. Five priority areas the tracking system intends to monitor include: (1) the extent that consumers and family members are involved in planning, implementing, and evaluating public managed behavioral health care services; (2) the extent that community-based mental health and substance abuse (MH/SA) providers, State and County MH/SA agencies are involved in planning, implementing, and evaluating public managed behavioral health care services; (3) benefits and actual quantity and quality of MH/SA services covered by managed care; (4) use of the term "medical necessity" in managed care contracts and in clinical guidelines and utilization review protocols to restrict access to prevention, early intervention, acute treatment, rehabilitation and recovery services; and (5) access to culturally competent services, providers, and practitioners. Future reports will elaborate as this information is more thoroughly tracked, focusing on priority issues and incorporating stakeholder perspectives. (SAMHSA)
Government Document
1996
Rockville, MD