Am J Psychiatry 1990; 147:967-973
Copyright © 1990 by American Psychiatric Association
Utilization management of mental health services by private third parties
GL Tischler
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06519.
The author describes approaches to utilization management and the growth of
this segment of the health care industry. Issues posed for the mental
health field by introducing a third party as the arbiter of care include
professional uncertainty and the discretionary behavior of practitioners
and third parties, the availability of clinically appropriate alternative
services, shifting of costs between the public and private sectors,
safeguarding privacy, accountability and the integrity of the review
process, financial risk versus professional responsibility, and the impact
of utilization management on the outcome of care.
