Managing Care, Not Dollars

By 1994 the total cost of health care in the United States approached $900 billion annually. In reaction to this explosive growth, the managed care industry, acting as the agent and administrator for government and health care payers, has taken an increasingly aggressive stance on controlling costs with a view toward hospitalization as the last option for mental health treatment. This new emphasis on cost containment demands effective and less costly alternatives to hospitalization. Although most clinicians have grudgingly accepted the inevitability of both managed care and cost controls, the question remains: How can we develop a coherent mental health care system that controls costs while working effectively for both patients and clinicians? In Managing Care, Not Dollars, leading clinical experts argue that in order to survive, psychiatric institutions must offer a full range of services to large numbers of patients.
Rather than concentrating on budget issues, clinicians and hospital administrators should use advances in treatment and technology to develop a coherent continuum of mental health care capable of delivering a wide variety of effective treatment options and alternatives to hospitalization. This guide to the creation and use of the emerging continuum of care provides an in-depth examination of the individual components of seven state-of-the-art treatment programs including suitable patients, treatment goals, staffing, physical plant, and special adaptations for children and the elderly. It also offers decision-making tools for managers to use to adapt their existing programs to survive in this new era and reviews the various public policy issues arising out of the health care transformation. By reading this book, clinicians, policymakers, and administrators can begin to grapple with the problem of learning to do more with less.