Economic grand rounds: types of practitioners and outpatient visits in a private managed behavioral health plan.
Types of privately insured outpatient treatment provided by in-network practitioners were examined in a national managed behavioral health care organization to consider how practitioner type and expertise are related to diagnoses of mental disorders, substance use disorders, or both. Using 2004 practitioner credentialing, patient enrollment, and claims data, the investigators found that two-thirds of claims for psychiatrists involved medication management and two-thirds also involved psychotherapy (an overlap of about 30%). Most patients with substance use disorders saw practitioners who had specialized alcohol or drug disorder training. Claims for patients with more complex co-occurring mental and substance use disorders indicate utilization of appropriately qualified practitioners with substantial experience on average.
Heller School for Social Policy and Management, Brandeis University, 415 South St., MS035, Waltham, MA 02454, USA. reif@brandeis.edu
Sharon
S
Reif
Constance
C
Horgan
Maria
M
Torres
Elizabeth
E
Merrick
D000553:Ambulatory Care / Q000191:economics* / Q000706:statistics & numerical data; D006801:Humans; D008329:Managed Care Programs / Q000191:economics* / Q000706:statistics & numerical data; D001523:Mental Disorders / Q000188:drug therapy / Q000191:economics / Q000628:therapy; D008605:Mental Health Services / Q000191:economics* / Q000706:statistics & numerical data; D011570:Psychiatry / Q000191:economics / Q000379:methods; D011613:Psychotherapy / Q000191:economics; D011619:Psychotropic Drugs / Q000191:economics / Q000627:therapeutic use; D014481:United States
D011619:Psychotropic Drugs