title: Cost, utilization, and utilization review of mental health services in a prepaid group practice plan.
abstract: The author describes the utilization review process, utilization patterns, and service cost of the Mental Health Service of the Health Insurance Plan of Greater New York (HIP). He finds that a mental health care delivery system within a health maintenance organization offers the advantages of sophisticated utilization review procedures, reduced cost per mental health incident, and a low utilization rate and low cost for psychiatric hospitalization. However, the HMO's return-to-function treatment goals may be too limited for the minority of patients who would benefit only from long-term intensive treatment. He recommends that cost accounting be based on cost per illness rather than cost per service.
mesh_terms: D000066:Accounting / Q000379:methods; D003365:Costs and Cost Analysis; D006279:Health Maintenance Organizations; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data; D006801:Humans; D001523:Mental Disorders / Q000628:therapy; D008605:Mental Health Services / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data*; D009518:New York; D014600:Utilization Review