PSYCHIATRIC MANAGED CARE AT A RURAL MEDDAC

Mental health costs at General Leonard Wood Army Community Hospital (G LWACH) have risen every year. In 1990, $2.7 million had been spent on CHAMPUS mental health costs, 58% of the entire CHAMPUS costs for the h ospital's catchment area. Gateway to Care, a plan of coordinated manag ed care conceived by Health Services Command, was initiated at GLWACH to give the commander and providers more flexibility to control costs and improve access to care. Five major changes were made under GLWACH' s mental health coordinated care project. In the first full year of th e project, CHAMPUS net costs were reduced to $1.4 million while more c omprehensive care was provided to beneficiaries. Cost reduction came p rimarily from dramatically increasing the size and scope of outpatient care to reduce inpatient admissions.