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Results for “Insurance, Psychiatric”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

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At least 559 records · Page 31Linked to original sources
PubMed1999

Mental health benefit limits and cost sharing under managed care: a national survey of employers.

Mental health services experts suggest that managed care diminishes the need for arbitrary benefit limits and consumer cost-sharing. Data from 577 health plans were used to test the hypotheses that health maintenance organizations (HMOs) and carve-out plans are less likely to use benefit limits or service exclusions, have more generous limits, and have lower cost-sharing requirements than non-HMOs and non-carve-out plans. The results show that HMOs were more likely to use service exclusions and did not make less use of benefit limits. Carve-outs were less likely to use some coverage exclusions. Comparisons of the stringency of limits and cost-sharing provisions did not show consistent differences.

Cost Sharing↗
PubMed1999

Development of a consumer survey for behavioral health services.

A consumer survey was designed to assess the quality of mental health and substance abuse services and evaluate insurance plans that provide such services. This paper describes the development of the Consumer Assessment of Behavioral Health Services instrument, which began with a review of existing consumer satisfaction surveys and input from several groups working toward development of nationally standardized satisfaction instruments. Consumer focus groups were used to ensure that all the important domains of quality were included, and group members were interviewed to ensure that all items on the instrument were understandable. Results of a pilot test conducted with 160 consumers, 82 enrolled in Medicaid plans and 78 in commercial plans, suggested that the survey was able to distinguish between the two groups in terms of evaluations of their care and insurance plans. Future efforts will focus on further testing of larger, more diverse samples and on developing scoring and reporting formats for the survey that will be useful to consumers and purchasers in choosing behavioral health services and plans.

Consumer Behavior↗
PubMed1985

Insurance.

Explore the source record for details and available documents.

Confidentiality↗
PubMed1982

Peer review of psychodynamic psychotherapy: generous versus restrictive reviewers.

American Psychological Association/CHAMPUS peer reviewers (N=168) evaluated clinical treatment reports that described psychodynamic treatment of middle-aged, depressed outpatients. Descriptive data are reported on the reviewer' recommendations concerning the reimbursement for previous and total (previous plus future) care. In addition, generous and restrictive reviewers are compared on their theorectical orientation, the self-reported factors affecting their review decisions, and their previously reported clinical practice patterns and attitudes toward psychological peer review. The implications of these findings for mental health quality assurance programs are discussed.

Health Benefit Plans, Employee↗
PubMed1982

Peer review of psychodynamic psychotherapy. Experimental studies of the American Psychological Association/CHAMPUS program.

Two factorial experiments examined the effects of reviewer theoretical orientation, documented treatment progress, and patient concurrence data on the peer review of clinical treatment reports that described long-term psychodynamic psychotherapy with a depressed, female outpatient. The experiments employed an unobtrusive methodology; peer reviewers believed that their evaluations would affect the disposition of actual mental health insurance claims. Subjects (n = 105) were American Psychological Association/Civilian Health and Medical Program of the Uniformed Services (CHAMPUS) peer reviewers of a psychodynamic, behavioral, or eclectic theoretical orientation. The psychodynamic reviewers, compared with the behavioral and eclectic reviewers, were more positive in their ratings of treatment and more generous in their future care reimbursement recommendations. Additionally, the data demonstrated that APA/CHAMPUS peer review was sensitive to reported treatment progress, and that reviewers of diverse orientations were equally responsive to documented progress in psychodynamic psychotherapy. The patient concurrence manipulation had little effect on the dependent measures. Implications for mental health quality assurance programs are discussed.

Health Benefit Plans, Employee↗
PubMed1991

A multifaceted approach to managed mental health care.

While many HMOs and insurance companies have contracted with outside managed mental health firms to control mental health utilization, ConnectiCare, an IPA Model HMO with nearly 100,000 members, manages its own mental health utilization with a multifaceted approach. How the system has evolved and preliminary results are presented to illustrate how an HMO can manage its own mental health care program while using local providers.

Concurrent Review↗
PubMed1992

Green Spring criteria for medical necessity of outpatient treatment and its use in a mental health utilization review program.

The authors have developed a two-tiered method for utilization review of outpatient mental health services. The methodology looks at initial and continued treatment evaluation and uses diagnosis, symptoms, plan of treatment, and the Global Assessment Scale (GAS) among other indicators to determine appropriateness of treatment. Preliminary program experience has been positive and is included.

Ambulatory Care↗
PubMed1978

Personality assessment and insurance reimbursement.

A contract between APA and OCHAMPUS has committed APA to developing a national peer review capability for the review of out-patient psychological services. This paper describes the review criteria which apply to personality assessment and psychological testing.

Humans↗
PubMed1978

Further comments on criteria for reimbursement for psychological assessments.

Bruhn (1978) has offered some comments about criteria for CHAMPUS reimbursement. These criteria are CHAMPUS-specific and subject to modification for other health plans. Deviations are subject to peer review and may be approved for reimbursement. Expert opinion is widely solicited to justify the criteria.

Child↗
PubMed1989

Regulatory policy and information deficiencies in the market for mental health services.

This paper addresses issues related to the regulation of the delivery of mental health services. The focus is primarily on regulations that are aimed at dealing with the consequences of imperfect information in the marketplace. The paper reviews and assesses what is known about the impact of regulations on efficiency and equity. One conclusion is that we know a fair amount about impacts of regulation on prices for mental health service and very little about effects on quality of care. A research agenda is proposed based on the knowledge available in 1988.

Attitude to Health↗