Quality Assurance in Managed Mental and Behavioral Health CareAssignment Expectations

PART 1: 4 PAGES-APA FORMAT-USE SUBHEADINGS-INCLUDE AT LEAST 4 PEER REVIEWED SCHOLARLY SOURCES. AT LEAST 2 SHOULD BE FROM PROVIDED READING LIST.

Describe the nature of managed care’s philosophy and initiatives directed at mental and behavioral health.
The steps taken to improve quality care
What works and what does not
Your recommendations for further or continued improvements

PART 2
4 PAGES-APA FORMAT-USE SUBHEADINGS-INCLUDE AT LEAST 4 PEER REVIEWED SCHOLARLY SOURCES. . AT LEAST 2 SHOULD BE FROM PROVIDED READING LIST.
FOR THE LAST PAPER (PART 2 SECTION) YOU WERE ASKED TO:
compare and contrast the ratings of two hospitals in one city of your choice and then please compare and contrast the ratings of two hospitals in another city of your choice. Please make sure this second city is in a different area of the country with different demographics (for example: Los Angeles and Kansas City or Miami and Salt Lake City).

Module 3, you will summarize the ratings in PART 2 OF THE LAST PAPER. Please identify the organizations that are rated the highest and lowest and explain the reasons.

PART 3: 1 PAGE: INCLUDE REF
One study states, “Mental health has proved especially vulnerable to the ravages of managed care because its patients tend not to be assertive about their right to treatment and because the subjective nature of emotional distress makes it easier to deny or restrict, by way of pre-approvals and treatment reviews, than many medical conditions, whose symptoms can be documented with blood tests or X-rays.”

Do you think this is a fair statement? Why or why not?
Discuss some of the responsibilities that managed care should have towards these individuals with mental health issues.
READING LIST
Aaronson, Becca. (5/17/2013). House Oks to Expand Mental Health in Managed Care. The Texas Tribune.

Anonymous (2013). Medicaid managed care for SUDs and mental health delayed in New York. Available in the Trident Online Library.

Alcoholism & Drug Abuse Weekly, 25(36), 7.

Barry, C. L. & Huskamp, H. A. (2011). Moving beyond parity- mental health and addiction care under the ACA. The New England Journal of Medicine, 365(11), 973-975.

Conner-Knox, J. (2012). Economic approaches to improving access to evidence-based and recovery-oriented services for people with severe mental illness. Canadian Journal of Psychiatry, 56(9), 523-530.

Knopf, Alison. (2013). Medicaid expansion means more managed care. Behavioral Healthcare, 33(2), 28-29.

Lustig, Stuart L; Blank, Alvin R; Cirelli, Robert J; Friedman, Sara R; Green, Frederick C; et al.(2013). Optimizing Managed Care Peer Reviews: Turning a “Doc to Doc” Talk Into Better Advocacy for Psychiatric Inpatients. Psychiatric Services, 64(8) 800-803. Retrieve from the Trident Online Library.

Maust, Donovan T; Oslin, David W; Marcus, Steven C. (2013). Mental health care in the accountable care organization, Psychiatric Services, 64(9), p. 908. Retrieve from the Trident Online Library.

Meredith, L. S., Branstrom, R. B., Azocar, F., Fikes, R., & Ettner, S. L. (2011). A collaborative approach to identifying effective incentives for mental health clinicians to improve depression care at a large managed behavioral healthcare organization. Administration and Policy in Mental Health and Mental Health Services Research, 38(3), 193-202.

Wolfe, Wes. McClatchy. (23 Nov 2013). Access to behavioral health care challenging. Tribune Business News [Washington].

Website
The Managed Care Information Center (2011). Retrieved from http://www.themcic.com/.

National Committee for Quality Assurance (2012). HEDIS and Quality Management. Retrieved fromhttp://www.ncqa.org/tabid/59/Default.aspx.

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