Shifting From External to Internal Provision of Mental Health Services in a Health Maintenance Organization
Abstract
A health maintenance organization whose mental health services had been supplied under contract by two successive external providers changed in 1978 to in-house provision of most services for both HMO and fee-for-service patients. The changeover necessitated a greatly enlarged staff, development of a treatmeat philosophy and utilization review procedures, and establishment of good communications with external providers who supplied inpatient services. One objective of the change to in-house services was to further reduce hospital admissions and hospitalization costs; comparisons of admissions and costs over a five-year period before and after the change indicated substantial reductions in both areas.
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