Academic psychiatry and health care reform: strategic initiatives for sustaining the clinical mission.
Health care reform has posed special challenges for departments of psychiatry in academic medical centers. This report describes one department's strategic responses to a marketplace with high penetration by managed care and provides examples of the kinds of faculty concerns that can arise when major departmental reorganizations are attempted. The department's successful adaptation to a radically altered professional environment is attributed to the following five initiatives: vertical integration and diversification of clinical programs, service line management, outcomes measurement, regional network development, and institutional managed care partnerships Although the authors did not design their adaptive efforts as a research study, they offer objective data to support their conclusion that the viability of their overall clinical enterprise has been sustained despite an external environment inhospitable to academic psychiatry.
McCabe
O Lee
OL
Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland 21205, USA. lmccabe@jhmi.edu
Gwon
Howard S
HS
McHugh
Paul R
PR
Breakey
William R
WR
Schwartz
Joseph M
JM
Clark
Michael R
MR
Kaminsky
Michael J
MJ
D000046:Academic Medical Centers / Q000458:organization & administration*; D018166:Health Care Reform; D006754:Hospital Restructuring; D006801:Humans; D008329:Managed Care Programs; D009935:Organizational Affiliation; D009936:Organizational Innovation; D011567:Psychiatric Department, Hospital / Q000458:organization & administration*; D011570:Psychiatry / Q000193:education* / Q000458:organization & administration*; D013663:Teaching / Q000379:methods; D014481:United States