Prospective payment for psychiatric services

Article Abstract:

A new analysis shows that the Medicare prospective payment system (PPS) would have to be reformed to include psychiatric care specialty hospitals and psychiatric departments of general hospitals whose financial risk would be too great under existing PPS. Congress set up PPS in 1983 to give the health care industry a motive for limiting rising costs but left psychiatric services out due to variations in treatment costs. However, Medicare discharge information for 1985 indicated that PPS rules could be modified to lower the financial risk while retaining cost-limiting incentives.

Psychiatric services, Mental health services

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Competition and community mental health agencies

Article Abstract:

The ability of community mental health agencies (CMHAs) to maintain subsidized care suffers when they must compete for patients with private-practice psychiatrists and health maintenance organizations. A 1989 survey of 633 CMHAs obtained data which, when subjected to two-stage least-squares analysis, confirmed the link between increasing competition and decreasing numbers of subsidized visits. The states should prevent this trend from denying outpatient care to impoverished patients who can obtain treatment nowhere else.

Economic aspects, Community psychiatric services, Community mental health services

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Prospective payment for hospital psychiatric services: is it needed in the 1990s?

Article Abstract:

Extending the Medicaid prospective payment system (PPS) to include hospital psychiatric services as Maqbool Dada, William D. White, Houston H. Stokes and Paul Kurzeja suggest would not be a comprehensive solution to the problem of rising costs. An objective assessment shows that PPS has failed to restrain the increasing price of non-psychiatric hospital care. A truly effective cost-containment strategy will only come as a part of a national health insurance system.

Psychiatric hospital care, Psychiatric hospitals

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