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The Effectiveness of Managed Care Techniques in the Contracted Provider Arrangement - Norfolk Demonstration Project
ACADEMY OF HEALTH SCIENCES (ARMY) FORT SAM HOUSTON TX HEALTH CARE ADMINISTRATION
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Health care expenditures in the United States exceeded 12 percent of the gross national product GNP and are subject to rise to 15 percent of GNP by the turn of the century. The high cost of health care in the civilian sector also plagues the Civilian Health and Medical Program of the Uniformed Services CHAMPUS for 6.2 million eligible beneficiaries in the Military Health Services System. The inflationary cost for mental health care has led to numerous demonstration projects which emphasize cost control and quality care. The Contracted Provider Agreement-Norfolk demonstration project places a fixed cost contractor, using managed care techniques, at risk to provide care in the Tidewater area where cost for mental health care has averaged twice the national average. The project has been successful at reducing cost, however the effort has not produced evidence that some of its alternative treatment measures, such as partial hospitalization, produces acceptable levels of clinical outcomes. The purpose of this study is to review the effectiveness of the utilization management process in the CPA-Norfolk project. The study will also compare the outcome measures cost, LOS, and incidence of rehospitalization between the CPA- Norfolk program and standard CHAMPUS. One-way analysis of variance for unequal cell sizes will be used as the primary statistical tool to test significance at the p .01 level.
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