Managed Behavioral Health Care: Summary Briefing of Performance Audits

Abstract

As complaints from employees and practitioners mounted, a number of employers have enlisted outside consultants to conduct performance audits of their managed behavioral health care providers. All employers, including the Federal Government, have compelling reasons for concern with the performance of health care systems. In addition to the hundreds of billions they spend each year on care of their own employees, through taxes and cost shifting they also finance a large portion of the care for added millions of Americans who have no insurance.

The following outlines the findings of audits of MBHOs conducted by J. Wrich & Associates, Inc., a Chicago based consulting firm with nearly 30 years experience in health systems performance. The audits summarized here were commissioned by employers and are of MBHOs which provide service to more than forty percent of the 160 million Americans enrolled in such plans.

The methodology incorporated both direct and indirect research methods to review two major categories of information: 1) The Providers Documentation and 2) Patient Files.