These programs are also known as managed behavioral health care, managed care, behavioral healthcare and are provided to Taft Hartley trusts and self-insured companies.

Utilization Review: Review of cases is conducted to assure appropriate length of stay, medical necessity and proper level of care.

Case Management: The EAP/MAP or MMHC group does all assessment and referral, authorizes all services, monitors all treatment, provides concurrent review and discharge planning for the behavioral healthcare program.

Management Information Systems: Benchmark information such as distribution of utilization, problem category breakdown, client satisfaction, and relapse rates by provider allows for cost effective management.

Quality Assurance: Client is followed from intake, assessment and referral through counseling, resolution and follow-up to ensure that the benefit dollar is judiciously spent and quality care is received in the managed mental healthcare program.

Pain Management Services:  A partnership with Integrated Pain Solutions (IPS), a multidisciplinary managed services organization, now provides a continuum of pain management services - call center, case management, care coaching, utilization management, provider network, centers of excellence, and physician education.

Managed Care Cost Effective Reports:
(Based on availability of data from TPA, a third-party administartor)

• Cost outcome by provider
• Cost outcome by diagnosis
• Relapse statistics by provider
• Average length of stay
• Utilization rate
• Price per unit of service
• Balance between inpatient/outpatient service

Management of treatment is the best overall way to contain costs.

The Benefits:

A managed mental health care program provides a continuum
of care which:

• Controls cost for mental health care benefits
• Provides the most cost effective treatment while ensuring
  quality of service
• Holds providers accountable to the client, employers and trusts
  who pay for the services

Health promotion and utilizing non-medical resources, when appropriate, are ways to capitalize on the health care cost containment opportunity.