Mental Health Care Quality Under Managed Care in the United States: A View From the Health Employer Data and Information Set (HEDIS)

Druss, Benjamin G.; Miller, Carolyn Levinson; Rosenheck, Robert A.; Shih, Sarah C.; Bost, James E.

doi:10.1176/appi.ajp.159.5.860

Cited by 35 publications

(25 citation statements)

References 16 publications

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“…Guideline-concordant depression treatment is associated with improvements in depression severity, better clinical and mental health quality of life outcomes, and higher rates of employment (Fortney et al 2001;Schoenbaum et al 2002). However, many patients fail to receive guideline-recommended levels of care (Druss et al 2002;McCarthy et al 2007;Robinson et al 2006).…”

mentioning

confidence: 99%

Does Consideration of Medicare Use Affect VA Evaluations of Treatment for New Episodes of Depression?

McCarthy

Zivin

Austin³

et al. 2008

Adm Policy Ment Health

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This report evaluates whether consideration of out-of-system use affects Veterans Affairs (VA) health system assessments of depression treatment. We measured effective medication management and optimal practitioner contacts among veterans whose VA data indicated a new episode of depression. Among 3,567 VA patients who were Medicare age-eligible, VA data indicated that 69% received recommended antidepressant coverage and 9% received recommended practitioner contacts. After including Medicare data, 295 patients (8%) no longer met inclusion criteria. Among the remainder, 3% received Medicare depression treatment and 0.5% were re-classified as having recommended contacts. Medicare use does not substantially supplement VA depression treatment.

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mentioning

confidence: 99%

Does Consideration of Medicare Use Affect VA Evaluations of Treatment for New Episodes of Depression?

McCarthy

Zivin

Austin³

et al. 2008

Adm Policy Ment Health

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“…In their unsettling Quality Chasm series, the Institute of Medicine reported on the large gap that exists between what is known to be effective care for mental health conditions and the treatment that is actually delivered (IOM 2001a(IOM , 2006(IOM , 2007. Research has shown, for example, that managed care companies deliver mental health care in accordance with standards of care only 48% of the time compared with 69% of the time for general health care (Druss et al 2002) and rates of provider treatment guideline adherence for mental health care are below 50% on average, and in some cases as low as 20% (IOM 2006). In particular, mental health providers' expertise in detecting and treating children's serious mental illness has been found lacking (GAO 2003).…”

Section: Limitations In Treatment Availability and Qualitymentioning

confidence: 99%

Using Systems of Care to Reduce Incarceration of Youth with Serious Mental Illness

Erickson

2011

American J of Comm Psychol

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Youth with serious mental illness come into contact with juvenile justice more than 3 times as often as other youth, obliging communities to expend substantial resources on adjudicating and incarcerating many who, with proper treatment, could remain in the community for a fraction of the cost. Incarceration is relatively ineffective at remediating behaviors associated with untreated serious mental illness and may worsen some youths' symptoms and long-term prognoses. Systems of care represent a useful model for creating systems change to reduce incarceration of these youth. This paper identifies the systemic factors that contribute to the inappropriate incarceration of youth with serious mental illness, including those who have committed non-violent offenses or were detained due to lack of available treatment. It describes the progress of on-going efforts to address this problem including wraparound and diversion programs and others utilizing elements of systems of care. The utility of systems of care principles for increasing access to community-based mental health care for youth with serious mental illness is illustrated and a number of recommendations for developing collaborations with juvenile justice to further reduce the inappropriate incarceration of these youth are offered.

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“…Yet the hypothesized relationship is likely more direct, hence testable by the designs used in these studies. Given that continuity of care is a suggested ethical aim of service delivery (Thornicroft & Tansella, 1999) and a common criterion for evaluating performance of mental health care systems (Druss, Miller, Rosenheck, Shih, & Bost, 2002;Rosenheck & Cicchetti, 1998), a review of relevant research is timely. The aim of this paper is to reexamine these key studies to summarize the evidence on the association between systems integration and continuity, identify strategies associated with increased continuity and suggest areas for further research.…”

Section: Introductionmentioning

confidence: 99%

Does Systems Integration Affect Continuity of Mental Health Care?

Durbin

Goering

Streiner

et al. 2006

Adm Policy Ment Health

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Continuity of care is a concern for mental health clients in the post deinstitutionalization era of community care. A proposed solution is systems integration. This paper reviewed research on systems integration, focusing on continuity of care outcomes. A positive association between systems integration and client continuity of care was consistently demonstrated. Better results were obtained in systems characterized by stronger management arrangements, fewer service sectors, and system wide implementation of intensive case management and centralized access to services. Future research should evaluate a wider range of systems integrating mechanisms, using client-based measures that more directly represent continuity of care experiences.

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Mental Health Care Quality Under Managed Care in the United States: A View From the Health Employer Data and Information Set (HEDIS)

Abstract: Better general medical care, transparency of reporting, and commitment of fiscal resources to clinical care predicted better mental health care performance for U.S. HMOs.

Cited by 35 publications

References 16 publications

Does Consideration of Medicare Use Affect VA Evaluations of Treatment for New Episodes of Depression?

Does Consideration of Medicare Use Affect VA Evaluations of Treatment for New Episodes of Depression?

Using Systems of Care to Reduce Incarceration of Youth with Serious Mental Illness

Does Systems Integration Affect Continuity of Mental Health Care?

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