A FACILITATED MODEL OF INPATIENT PSYCHIATRIC-CARE

The authors describe a model for an effective partnership between a la rge health maintenance organization and a fee-for-service acute inpati ent psychiatric unit. They present data from five years of experience with the model on a unit serving a catchment area of one million plan members. The model, which is based on ''facilitated'' care rather than managed care, emphasizes crisis intervention and a strong medical ori entation. The HMO contracted with seven psychiatrists to provide treat ment and helped develop a value system shared by the physicians and ho spital staff. A clinician represented the HMO on the unit and played a key decision-making role in patient care. A total of 4,945 patients w ere admitted over five years. Costs per admission were reduced 47 perc ent during this period; the readmission rate was 16.9 percent. Impleme ntation of the model resulted in the delivety of high-quality cost-eff ective care.