Managed care hitting psychiatric practices

Article Abstract:

Employers' increasing use of managed care systems to provide mental health care services is affecting psychiatrists, financially. Psychiatrists not associated with managed care systems are receiving fewer referrals and fee-for-service patients. Psychiatrists who are associated with managed care systems could experience income reductions if they rely heavily on hospital admissions for income. Psychiatrists who treat patients in ambulatory settings could actually benefit from increasing use of managed care systems. Results of an InterStudy survey of 409 health maintenance organizations are presented.

Compensation and benefits, Statistics, Psychiatric services, Mental health services, Health maintenance organizations, Psychiatrists

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Study questions savings of Medicaid managed care

Article Abstract:

The results of a Rand Corp study indicate that managed care health plans may not necessarily save states money. An analysis of two managed care programs, one in Florida and the other in New York, showed that the success of these programs was contingent on the ability of the states to set capitation rates correctly. Both programs based their rates on participants in fair health. The Florida program saved money because it attracted sicker patients. The New York program lost money because it attracted healthier patients.

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Indemnity insurers shifting to drug formularies

Article Abstract:

Blue Cross of Western New York Inc, in an effort to control rising drug costs, is using a drug formulary for its indemnity and managed care patients. Physicians are urged to prescribe from a list of generic drugs and reasonably priced brand name products. Pres H. John Rubenstein of the Erie County Medical Society agrees that costs must be contained, but presses the need for choice of the most efficacious drug.

Management, Practice, Physicians, Medical professions, Health insurance, Blue Cross of Western New York Inc.

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