The Role of a Behavioral Health Medical Director in Medicaid Managed Care

The Role of a Behavioral Health Medical Director in Medicaid Managed Care Psychiatr Q (2008) 79:33–42 DOI 10.1007/s11126-007-9065-8 IN TRO DUCTIO N The Role of a Behavioral Health Medical Director in Medicaid Managed Care Juliana I. Ekong Published online: 25 January 2008 Springer Science+Business Media, LLC 2008 Health expenditures in the United States continue to rise even when compared to inflation. As a share of the gross domestic product (GDP), health spending has increased from 5% in 1960 to over 16% in 2006 [1]. To stop this trend many states have contracted with managed care companies to manage the health benefits of all or some of their Medicaid recipients. The hope is that such management will allow for appropriate allocation of health care dollars while improving the overall quality of care. Although this move to managed care has been embraced by many recipients of care, many providers of care, especially in the arena of behavioral health, may remain antagonistic towards and suspicious of Medicaid managed care compa- nies. The author describes why she decided to leave direct clinical care to pursue a career in Medicaid managed care. She discusses the key aspects of her role as a Behavioral Health Medical Director, focusing on her role in ensuring the appropriate allocation of http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Psychiatric Quarterly Springer Journals

The Role of a Behavioral Health Medical Director in Medicaid Managed Care

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Publisher
Springer US
Copyright
Copyright © 2008 by Springer Science+Business Media, LLC
Subject
Medicine & Public Health; Psychiatry; Public Health; Sociology, general
ISSN
0033-2720
eISSN
1573-6709
D.O.I.
10.1007/s11126-007-9065-8
Publisher site
See Article on Publisher Site

Abstract

Psychiatr Q (2008) 79:33–42 DOI 10.1007/s11126-007-9065-8 IN TRO DUCTIO N The Role of a Behavioral Health Medical Director in Medicaid Managed Care Juliana I. Ekong Published online: 25 January 2008 Springer Science+Business Media, LLC 2008 Health expenditures in the United States continue to rise even when compared to inflation. As a share of the gross domestic product (GDP), health spending has increased from 5% in 1960 to over 16% in 2006 [1]. To stop this trend many states have contracted with managed care companies to manage the health benefits of all or some of their Medicaid recipients. The hope is that such management will allow for appropriate allocation of health care dollars while improving the overall quality of care. Although this move to managed care has been embraced by many recipients of care, many providers of care, especially in the arena of behavioral health, may remain antagonistic towards and suspicious of Medicaid managed care compa- nies. The author describes why she decided to leave direct clinical care to pursue a career in Medicaid managed care. She discusses the key aspects of her role as a Behavioral Health Medical Director, focusing on her role in ensuring the appropriate allocation of

Journal

Psychiatric QuarterlySpringer Journals

Published: Jan 25, 2008

References

  • General medical and pharmacy claims expenditures in users of behavioral health services
    Kathol, RG
  • Two-year outcomes of fee-for-service and capitated medicaid programs for people with severe mental Illness
    Cuffel, BJ

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