Managed process, due care: structures of accountability in health care.
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The economic pressures of cost containment, pricing competition, and managed care have bootstrapped the application of health economic evaluation into the specialized area of pharmacoeconomics. The rapid development of the field has lead to criticism within the discipline and skepticism from consumers of pharmacoeconomic studies. The need for consensus upon standards of design and analysis will result in guidelines and more stringent peer review. The relative merits of current approaches are reviewed with respect to the limitations and generalizability of each type of study and common pitfalls in the design, analysis, and promotion of pharmacoeconomic studies. Future trends and regulatory issues are discussed. Finally, the role of pharmacoeconomics in drug development and marketing is evaluated.
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Many employers are contracting mental or behavioral health services separately from other types of health care. Capitation rates are paid for a defined set of benefits. Mental health services are capitated in two ways; both approaches are discussed.
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For the first time, instances where HMO strategies to save money collide with the patient's right to receive quality of care have come under the scrutiny of the law.
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As managed care increases in influence, dentists must be prepared to document the efficacy of all treatment modalities in order to maintain control over the care their patients receive. We, rather than third parties, are ultimately accountable for the results of the care we provide. The outcomes assessment process can yield essential, clear evidence of the efficacy, cost-effectiveness and benefits of the care we provide to patients.