The introduction of the concept of managed care into mental and
physical health care appears to be a juggernaut of unparalleled
impact. The two extremes of thought about this impact are (I) that
managed care is a villainous foe to be resisted in order to bring
back the earlier halcyon years of independence in practice
decisions with greater reimbursement for psychologists' services or
(2) that managed care is a laudatory attempt to restrain health
care costs that are out of control and spiraling upward by rooting
out mismanagement and reversing financial incentives to provide
unnecessary care. The former view calls managed health care such
names as "mangled care" and distributes bumper stickers stating
"Just Say No to HMOs. " The latter view points to the slowdown of
increases in health care expenditures and the enhancement of health
care affordability and appropriateness for greater numbers of
persons resulting from managed care cost-containment strategies and
service review procedures. Mental or behavioral health care has
been as strongly impacted as medical care under managed care. Where
managed care has forced practitioners' attention to validated
procedures and to examining previous wasteful practices, we ap
plaud the movement. Where managed care has had adverse impact, we
think there needs to be greater public, legal, and regulatory
attention to its excesses and abuses."
General
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