An economic and clinical rationale for changing utilization review practices for outpatient psychotherapy.
The growth of managed care has led to greater cost consciousness in the financing and delivery of mental health and substance abuse services. The authors examine whether pressures to reduce the costs associated with mental health and substance abuse treatment have led to the overapplication of a popular managed care strategy, utilization review (UR), to the management of outpatient psychotherapy benefits. Several arguments are presented highlighting why changing outpatient psychotherapy UR practices would be in the best economic and clinical interests of all involved parties, including payers, managed care organizations (MCOs), mental health consumers, and providers. A number of alternatives to the aggressive management of outpatient psychotherapy benefits are outlined and discussed.
Hennessy
K D
KD
Office of Health Policy, U.S. Department of Health and Human Services, Washington, DC 20201, USA.
Green-Hennessy
S
S
D003156:Community Mental Health Services / Q000191:economics / Q000706:statistics & numerical data*; D003363:Cost Control / Q000379:methods; D003362:Cost-Benefit Analysis; D006801:Humans; D008329:Managed Care Programs / Q000592:standards*; D001523:Mental Disorders / Q000191:economics* / Q000628:therapy; D011613:Psychotherapy / Q000191:economics*; D014481:United States; D014600:Utilization Review / Q000379:methods*