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Case review and quantity of outpatient care

Published Online:https://doi.org/10.1176/ajp.145.8.1003

Case review for patients belonging to a health maintenance organization was implemented in a hospital-based, multidisciplinary, outpatient clinic after the influx of 28,000 Medicaid enrollees. One-year follow- up of 138 patients with prepaid mental health insurance and 283 patients with fee-for-service mental health insurance revealed an annual mean of 6.1 treatment sessions; 78% completed treatment within eight sessions. The modal treatment was a single visit. Prepaid and fee- for-service patients did not differ in amount of care, although significant differences were found for insurance subgroups. These preliminary results suggest that case review has little effect on quantity of care.

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