United Behavioral Health's decision to retain case management for mental health even as it loosens restrictions on doctors is a mistake ("HMO's switch no help for therapists," Business, Nov. 12).
This is especially the case in the realm of outpatient psychotherapy. Heavy-handed and expensive case review makes no economic sense given that over the past 20 years, outpatient psychotherapy costs have remained constant, accounting for 1.6 percent to 4 percent of the total health care dollar, according to several studies. Private-employer mental health care spending declined by roughly 50 percent between 1988 and 1997. In contrast, overall health spending by employers declined only by 7.4 percent, according to the Hay Study. The report also notes that unlike the shift in the general health care sector toward greater outpatient care, behavioral health services are being squeezed on both the inpatient and outpatient sides.
With all the continued focus on cost containment on the part of managed care companies, little attention is being paid to the overall costs of untreated or poorly treated psychological and emotional disturbances. …