Introduction
Behavioral health programs have in the recent past experienced changes at a fast rate (Sabin & Daniels, 2001). Health organizations either affiliate, multiply, merge or buy one another with the competing trend of the market economy. It has been argued that there is a need for the managed health care organizations to be accountable by proving that their programs and policies are geared towards promoting the necessary patient care despite the existing constraints due to inadequate resources (Sabin & Daniels, 1998). This paper will find out what issues have to lead to these changes and secondly, find what challenges are experienced when trying to find the data for measuring the outcomes of a behavioral health care organization.
Issues contributing to behavioral healthcare organizations realize the growing need to reorganize, merge, network, or affiliate
Organized mission and financial solutions
Behavioral health care organizations have policies and programs that are targeted to provide quality and reasonable health care to economically disadvantaged people. Such programs focus on the low-income urban population (Ludden, Feldman & Croze, 1994). As a result of this, these organizations serve a huge number of people and consequently the costs of health care providers are likely to increase considerably. For these organizations to achieve their mission of providing quality health care to the many urban poor there is need for organized missions that will put the financial factors into account. One of the ways to achieve this is through merging. An example of this scenario is the merge between Harvard Community Health Plan and Pilgrim Health Care which merged in 1995 to form Harvard Pilgrim Health Care resources (Sabin & Daniels, 1998). These two organizations were non-profit making organizations that had strong commitment to the provision of health care to the low-income populations. Before the merger the two organizations had made great losses and were not able to provide efficient services to the members but after the merger the service delivery became organized and the losses were cut down. This was attributed to the organization in terms of resources after the merger and also the networks of community health centers with high-level expertise organized by the Harvard Pilgrim Health Care (Sabin & Daniels, 1998).
Need for integrated health care
Behavioral health care organizations have also realized the need to integrate their services. Through affiliations, medical care organizations can provide reliable and high-quality health services. For instance, when the Mental Health Management of America lost a contract it had with Massachusetts Medicaid in 1996, Neighborhood Health Plan was awarded the same contract. Neighborhood Health Plan decided to work with Beacon Health Strategies which was another company founded by some of the top executive officers of Mental Health Management of America. Through the network of knowledge and experience provided by Beacon Health Strategies, the two organizations were able to integrate their services and were confident to succeed (Sabin & Daniels, 1998).
Reason for Challenge in collecting the data needed to support an outcome-based data system
The outcomes of behavioral health care system are determined by the success or the failure that results from service delivery. To determine these outcomes, specific data on the performance of a behavioral healthcare system need to be collected. However, the collection of this data is not easy because there are constraints associated with this process. The major challenge in determining the outcome data is because there are no organizational structures that are put in place to determine which organization yields results that are better than another organization. When to organizations merge or affiliate, they should be held accountable for their activities inpatient care and resource use (Sabin & Daniels, 2001).
References
- Ludden, J. M., Feldman, S., & Croze, C., (1994). Integrated or carved out: the future of behavioral health programs. Behavioral Healthcare Tomorrow, 3 (6):40-48.
- Sabin, J. E., & Daniels, N., (1998). The ethics of accountability in managed care reform. Health Affairs, 17 (5): 50-64.
- Sabin, J. E., & Daniels, N., (2001). Managed Care: Public-Sector Managed Behavioral Health Care: Integrated Versus “Carve-Out” Care. Boston: Rand Graduate School.