NOTICE: The project that is the subject of this report was approved by the Governing Board of the National Research Council, whose members are drawn from the councils of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine. The members of the committee responsible for the report were chosen for their special competences and with regard for appropriate balance.

This report has been reviewed by a group other than the authors according to procedures approved by a Report Review Committee consisting of members of the National Academy of Sciences, the National Academy of Engineering, and the Institute of Medicine.

The Institute of Medicine was chartered in 1970 by the National Academy of Sciences to enlist distinguished members of the appropriate professions in the examination of policy matters pertaining to the health of the public. In this, the Institute acts under both the Academy's 1863 congressional charter responsibility to be an adviser to the federal government and its own initiative in identifying issues of medical care, research, and education. Dr. Kenneth I. Shine is president of the Institute of Medicine.

Support for this project was provided by the Center for Substance Abuse Treatment of the Substance Abuse and Mental Health Services Administration, U.S. Department of Health and Human Services. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the view of the organizations or agencies that provided support for the project.

Library of Congress Cataloging-in-Publication Data

Managing managed care : quality improvements in behavioral health / Margaret Edmunds . . . [et al.], editors ; Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care, Division of Neuroscience and Behavioral Health [and] Division of Health Care Services, Institute of Medicine.

p. cm

Includes index.

1. Managed mental health care—United States—Quality control. 2. Managed mental health care—Accreditation—United States. I. Edmunds, Margaret. II. Institute of Medicine (U.S.). Committee on Quality Assurance and Accreditation Guidelines for Managed Behavioral Health Care.

[DNLM: 1. Mental Health Services—organization & administration—United States. 2. Managed Care Programs—organization & administration—United States. 3. Quality Assurance, Health Care—standards—United States. WM 30 M2666 1997]

RC480.5.M325 1997

362.2′00973—dc21

DNLM/DLC

for Library of Congress

97-20004

CIP

The serpent has been a symbol of long life, healing, and knowledge among almost all cultures and religions since the beginning of recorded history. The image adopted as a logotype by the Institute of Medicine is based on a relief carving from ancient Greece, now held by the Staatlichemuseen in Berlin.