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Biomedical subjects

T R Hadley

Publications and source records attributed to T R Hadley.

26 records · Page 2Linked to original sources
PubMed1989

Opportunities and risks in Philadelphia's capitation financing of public psychiatric services.

The city of Philadelphia was one of nine sites selected by the Robert Wood Johnson (RWJ) Foundation and the U.S. Department of Housing and Urban Development (HUD) to receive five-year funding to improve the delivery, quality and cost efficiency of public mental health services to its chronically mentally ill population. As part of the RWJ project, the city plans to restructure its delivery and reimbursement system, creating a not-for-profit central authority which will function as a health insurance organization (HIO) responsible for coordinating and managing psychiatric care to Medicaid clients. Operating under a model of capitation, the central authority will employ diverse funding mechanisms to finance and manage service delivery. This paper examines the benefits and risks inherent in the reorganization of Philadelphia's mental health service system under a capitation financing model. Issues considered include cost and utilization patterns, treatment outcomes, providers and their staffing patterns, service mix and the overall impact of capitation on clients.

Capitation Fee↗
PubMed1989

Philadelphia's capitation plan for mental health services.

Dr. Sharfstein's Introduction: Prospective payment is the major economic change that is reshaping the delivery of medical care. Capitation financing for the chronic mentally ill is an innovative and promising alternative to underfunded and bureaucratically rigid public programs on the one hand and underfunded retrospective cost-based Medicaid programs on the other. This month's column describes one such capitation plan. Its impact on the target population as well as on the use of resources by persons with long-term and severe mental illnesses will require close evaluation.

Capitation Fee↗
PubMed1988

Accreditation, certification, and the quality of care in state hospitals.

Data on 216 state psychiatric hospitals were analyzed to determine whether accreditation by the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) or certification by the Health Care Financing Administration (HCFA) were related to seven hospital characteristics generally accepted as reflecting quality of care. The characteristics were average cost per patient, per diem bed cost, total staff hours per patient, clinical staff hours per patient, percent of staff hours provided by medical staff, bed turnover, and percent of beds occupied. While a majority of the hospitals had either JCAHO accreditation, HCFA certification, or both, analysis revealed a weak relationship between accreditation or certification status and the indicators of quality of care. Accredited or certified hospitals were, however, more likely to have higher values on specific indicators than hospitals without accreditation.

Accreditation↗
PubMed1987

Use of manpower data in an integrated database for program efficiency analysis: an example from a statewide community mental health system.

This article describes a method for systematically utilizing manpower data to analyze program efficiency of community mental health services. Examples of how analyses of performance data can be substantially enhanced by integrating manpower staffing data with other key financial, client, and service volume variables are provided.

Community Mental Health Services↗