Are competing psychotherapists manageable?
Behavioral health care faces major overhauling. The twin objectives of improved access and greater efficiency require reorganization of the delivery system from a disjointed array of competitors to an integrated continuum of collaborators. Ironically, the motif for achieving such a change is that of competition. This article questions reform through market forces alone and suggests a guided five-step process: guaranteeing the right to necessary care, regionalizing resources under capped budgets, replacing fee-for-service reimbursement with prospective payment, aligning continuing education requirements with performance-defined gaps in knowledge, and funding professional retraining. Shared accountability is proposed as an alternative to the problematic ethic of competition.
MedCo Behavioral Care Systems, Burlington, MA.
M J
MJ
Bennett
D002983:Clinical Competence / Q000592:standards; D016536:Competitive Medical Plans / Q000191:economics*; D003266:Continuity of Patient Care / Q000458:organization & administration; D004465:Economic Competition; D004496:Education, Continuing / Q000592:standards; D017050:Episode of Care; D018166:Health Care Reform; D006801:Humans; D008605:Mental Health Services / Q000191:economics*; D011445:Prospective Payment System / Q000191:economics; D011613:Psychotherapy / Q000191:economics*; D012040:Regional Health Planning / Q000458:organization & administration; D014481:United States