Patients' and providers' perceptions of outpatient treatment termination in a managed behavioral health organization

Objective: A common complaint about managed care is that treatment decision s of patients and providers are frequently altered by concurrent review of ongoing outpatient treatment. The objective of this study was to examine th is perception from the perspectives of patients and providers. Methods: A t otal of 190 patients and their providers were surveyed about the reason tha t outpatient treatment was terminated, The sample was randomly drawn from c ompleted outpatient treatment episodes of a large national managed behavior al health organization. Results: In more than three-quarters of the cases, outpatient treatment ended because patients and providers agreed that treat ment goals were partially or completely met. Only 5 percent of patients and 3 percent of providers said that treatment ended because the managed care organization denied ongoing treatment. Agreement between patient-provider p airs was generally poor regarding the perceived reason for termination, exc ept when termination was attributed to concurrent review by the managed beh avioral health organization. Conclusions In this study of a single large ma naged behavioral health organization, outpatient treatment was most likely to end based on the decisions of patients and providers rather than utiliza tion review decisions.