title: Patients' and providers' perceptions of outpatient treatment termination in a managed behavioral health organization.
abstract: OBJECTIVE
  A common complaint about managed care is that treatment decisions of patients and providers are frequently altered by concurrent review of ongoing outpatient treatment. The objective of this study was to examine this perception from the perspectives of patients and providers.
  
  
  METHODS
  A total of 190 patients and their providers were surveyed about the reason that outpatient treatment was terminated. The sample was randomly drawn from completed outpatient treatment episodes of a large national managed behavioral health organization.
  
  
  RESULTS
  In more than three-quarters of the cases, outpatient treatment ended because patients and providers agreed that treatment goals were partially or completely met. Only 5 percent of patients and 3 percent of providers said that treatment ended because the managed care organization denied ongoing treatment. Agreement between patient-provider pairs was generally poor regarding the perceived reason for termination, except when termination was attributed to concurrent review by the managed behavioral health organization.
  
  
  CONCLUSIONS
  In this study of a single large managed behavioral health organization, outpatient treatment was most likely to end based on the decisions of patients and providers rather than utilization review decisions.
authors.affiliation: United Behavioral Health, 425 Market Street, 27th floor, San Francisco, CA 94105, USA. brian_cuffel@uhc.com
authors.forename: B
authors.initials: B
authors.lastname: Cuffel
authors.forename: J
authors.initials: J
authors.lastname: McCulloch
authors.forename: R
authors.initials: R
authors.lastname: Wade
authors.forename: L
authors.initials: L
authors.lastname: Tam
authors.forename: R
authors.initials: R
authors.lastname: Brown-Mitchell
authors.forename: W
authors.initials: W
authors.lastname: Goldman
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000191:economics; D001291:Attitude of Health Personnel; D003211:Concurrent Review; D003363:Cost Control / Q000639:trends; D005260:Female; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000191:economics; D001523:Mental Disorders / Q000191:economics / Q000628:therapy*; D008875:Middle Aged; D017060:Patient Satisfaction; D011613:Psychotherapy / Q000191:economics; D014481:United States