Managed Care Services: Policy, Programs, And Research

MANAGED CARE SERVICES This page intentionally left blank MANAGED CARE SERVICES Policy, Programs, and Research Nancy W. Veeder Boston College Wilma Peebles-Wilkins Boston University New York Oxford OXFORD UNIVERSITY PRESS 2001 Oxford University Press Oxford New York Athens Auckland Bangkok Bogota Buenos Aires Calcutta Cape Town Chennai Dar es Salaam Delhi Florence Hong Kong Istanbul Karachi Kuala Lumpur Madrid Melbourne Mexico City Mumbai Nairobi Paris Sao Paulo Shanghai Singapore Taipei Tokyo Toronto Warsaw and associated companies in Berlin Ibadan Copyright © 2001 by Oxford University Press Published by Oxford University Press, Inc. 198 Madison Avenue, New York, New York, 10016 http://www.oup-usa.org Oxford is a registered trademark of Oxford University Press. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior permission of Oxford University Press. Library of Congress Cataloging-in-Publication Data Veeder, Nancy W. Managed care services : policy, programs, and research / Nancy W. Veeder, Wilma Peebles-Wilkins. p. cm. Includes bibliographical references and index. ISBN 0-19-513429-X (alk. paper)—ISBN 0-19-513430-3 (pbk. : alk. paper) 1. Managed mental health care. 2. Managed care plans (Medical care) 3. Community mental health services. I. Peebles-Wilkins, Wilma II. Title. RA413.V44 2000 362.2'0425—dc21 00-037471 Printing (last digit): 10 9 8 7 6 5 4 3 2 1 Printed in the United States of America on acid-free paper CONTENTS Foreword Contributors vii xi INTRODUCTION Managed Health and Behavioral Health Care Services Delivery: A Complex, Interrelated System of Policies, Programs, and Research 1 PART ONE The Context of Human Service Practice in Managed Care Environments 11 1 The Macroeconomic Impact of Managed Care 15 Judith Shindul-Rothschild 2 Biotechnology and Managed Care: Effects on Health Care Cost, Clinical Practice, and Education of Health Care Professionals 31 Elizabeth Pearson Philp and Barbara Berkman 3 The Intersection of Fee-for-Service, Managed Health Care, and Cultural Competence: Implications for National Health Care Policy and Services to People of Color 50 King Davis 4 Ethics and Managed Care Policy 74 Frederic G. Reamer 5 System Care Management: Purpose, Structure, and Function 97 Susan Saunders V vi Contents PART TWO Managed Care: Services Delivery Domains for Special Needs and At-Risk Populations 117 6 Managed Care and Child Welfare Practitioner Training Needs 121 Vivian H. Jackson, Charlotte McCullough, and Jan McCarthy 7 Managed Care and Care Management for Older Adults 150 Scott Miyake Geron 8 Managed Care and the Ecological Perspective: Meeting the Needs of Older Adults in the Twenty-First Century 163 Roberta R. Greene and W. Patrick Sullivan 9 Outcomes Research for Children and Adolescents: Implications for Children's Mental Health and Managed Care 187 Susan B. Stern 10 Facilitating the Enrollment of Elderly a