Casebook for Managing Managed Care: A Self-Study Guide for Treatment Planning, Documentation, and Communication

by Bjorck, Jeffrey P.

• ISBN13: 9780880487832
• ISBN10: 0880487836
• Edition: 1st
• Format: Spiral Bound
• Copyright: 2000-03-01
• Publisher: AMERICAN PSYCHIATRIC PUBLISHING INC
• More Book Details

Summary

In today's environment of managed care, practitioners face more daunting challenges than ever: treatment authorizations are becoming more difficult to obtain, as are referrals to other healthcare practitioners, which are increasingly performance based. Into this competitive environment comes Casebook for Managing Managed Care: A Self-Study Guide for Treatment Planning, Documentation, and Communication. Dedicated to helping mental healthcare practitioners clearly articulate and prove the value of what they provide patients within the managed care system, this foundational text uniquely fills a gap in the literature by providing a user-friendly, self-contained tutorial for the Patient Impairment Profile (PIP) documentation method. The PIP combines impairment terminology, the impairment profile, and the various treatment plan components to create a common language for describing behavior-based patient dysfunction and communicating the clinical rationale for treatment. As a model for treatment plan development, the PIP system trains the practitioner (or treatment team) in the "must-have" skills needed for todays managed care environment. Here practitioners will find explicit instructions about how to Communicate treatment needs convincingly Distinguish effectively between goals, objectives, and interventions Track progress over time Document treatment summaries efficiently Using clear language and a wide array of case vignettes, the Casebookdemonstrates how using PIPS can streamline the documentation, communication, and decision-making processes. The Casebookcontinues the groundbreaking tradition of its predecessors: Managing Managed Care: The Mental Health Practitioner's Survival Guide(Goodman et al. 1992) and Managing Managed Care II: A Handbook for Mental Health Professionals, Second Edition(Goodman et al. 1996). It is uniquely valuable both as a stand-alone instructional text and as a companion to the second edition, which introduced the Patient Impairment Lexicon and the PIP system itself. The Casebook'supdates to the Impairment Lexicon definitions that first appeared in Managing Managed Care IIare based on the authors' ongoing psychometric evaluation and research. This practical text will find its way onto the bookshelves of mental healthcare practitioners and managed care personnel alike. Psychiatrists, clinical psychologists, clinical social workers, marriage and family therapists, and psychiatric nurses-especially those participating as managed care providers-and case managers and utilization reviewers within managed care organizations, regardless of background, will find a framework for success within these pages. The Casebook'sbroad appeal also extends to both students in healthcare disciplines and the graduate programs that train them, and to psychiatric/behavioral healthcare organizations and facilities (inpatient, outpatient, and residential), where it will be used for treatment planning.

Author Biography

Jeffrey P. Bjorck, Ph.D., is an Associate Professor of Psychology at Fuller Theological Seminary's Graduate School of Psychology in Pasadena, California. He is also a licensed clinical psychologist in private practice. Dr. Bjorck obtained his Doctor of Philosophy degree from the University of Delaware, having completed his internship at the University of Oklahoma Health Sciences Center. He has served on the faculty of Fuller Seminary's Graduate School of Psychology for the past 9 years, where his teaching responsibilities include courses in Psychometric Theory, MCMI-III Assessment, Human Learning, and Multimodal Therapy. Dr. Bjorck also conducts empirical research, including the ongoing psychometric evaluation of the Patient Impairment Lexicon, which provides the basis for the Patient Impairment Profile system outlined in this text and its companion, Managing Managed Care II: A Handbook for Mental Health Professionals (Goodman, et al. 1996).

Janet A. Brown, R.N., C.P.H.Q., is a consultant in quality, utilization, and risk management with psychiatric and medical-surgical, acute and ambulatory, healthcare organizations, all of which are now positioning for managed care. Ms. Brown has 22 years of experience in the evaluation, development, and implementation of effective strategies, systems, and processes to meet federal and state regulations, accreditation standards, and review requirements, as well as managed care and employer/payer information needs. Ms. Brown is the author of The Healthcare Quality Handbook: A Professionals Resource and Study Guide, currently in its 14th edition, and serves as instructor for quality management professionals preparing for the certification examination. She has chaired the national Healthcare Quality Educational Foundation and was the 1995--1996 president of the National Association for Healthcare Quality.

Michael Goodman, M.D. (1945--1996), was a clinical psychiatrist in private practice in Beverly Hills and Pasadena, California. He attended Tufts Medical School and completed his psychiatry residency at Northwestern University in Chicago, Illinois. Dr. Goodman served for 14 years as a physician advisor with the former California Professional Standards Review Organization and its current successor, California Medical Review, Inc. He was also a consultant in managed mental healthcare with treatment programs and practitioner groups participating in newer managed deliver models. Dr. Goodman was an assistant professor at the UCLA School of Medicine, Department of Psychiatry and Neurobehavioral Sciences, Los Angeles, California. He was also a mental healthcare consultant for the American Medical Association's Doctors Advisory Network, which provides ôhands-onö assistance with managed care to members of the American Medical Association. He died on June 17, 1996.

Table of Contents

About the Authors
Preface
Acknowledgments
Introduction	p. 1
The Impairment Inventory: Identifying Impairments	p. 13
The Impairment Inventory: Rating Impairment Severity	p. 37
The Patient Impairment Profile	p. 71
Goals and Objectives: Performance Measures for Managed Care	p. 103
The Treatment Plan: Selecting Interventions	p. 131
Tracking Patient Progress	p. 149
The Discharge Summary: Documenting Treatment Course	p. 169
Epilogue	p. 195
DSM-IV Diagnostic Criteria for the Vignette Patients	p. 199
Empirical Research Articles
Patient Impairment Lexicon: A Psychometric Analysis	p. 213
Patient Impairment Lexicon: A Validation Study	p. 237
References	p. 253
Index	p. 255
Table of Contents provided by Blackwell. All Rights Reserved.