In An Introduction to Human Services, managed care is said to be “A set of tools or methods designed to manage resources and deliver human services, especially in the areas of health care and mental health.” (Woodside 2011) Before managed care, help for clients was provided on a fee-for-service basis, the cost of which was paid for by the client, the client’s insurance provider, or a client-care-providing organization or agency.
Managed care is defined by Barron’s (2006) as a “plan to control employer’s health care cost through the introduction of practice guidelines or protocols for health care providers, and to improve the methods used by employers and employees to select health care providers. The goal of the plan is to create a financial accounting system in order to manage the impact of medical treatment on the patient’s clinical response and quality of life.”
The Mental Health Patient’s Bill of Rights (American Psychological Association, 2006) outlines what patients can expect from mental health services, and details appropriate questions clients can ask of the human service professional. Such issues as the right to know, confidentiality, determination of treatment and nondiscrimination are explained in detail.
One of the ways that managed care is changing how human services are provided is through the use of external reviews to help define the problem, recommend treatment type and location, and to evaluate evidence that supports the need for treatment. The assessment, planning, coordinating and monitoring of treatment is the purpose of care coordination, to ensure efficiency and high-quality service for clients.
The increase in paperwork necessary for servicing clients is another influence of managed care. A request for services for a client can include many documents, such as a detailed description of the client’s problem and/or a request for reimbursement. The informational systems used by service organizations