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Some early lessons from the rise of managed behavioral health care in the United States / Commentary

John E. Schowalter, MD

Yale Child Study Center, New Haven, Conn., USA

Address for correspondence: John E. Schowalter, MD, Yale Child Study Center, POB 207900, New Haven, Connecticut 06520-7900, USA

Abstract: In the 1990s the United States has, because of an unacceptable su rge in health care costs, made a revolutionary shift of the reimbursement process from fee-for-service to managed care's restricted, discounted and capitated payment approaches. Mental health care has for 150 years largely been subsidized by tax supported hospitals and clinics. Federal and state governments have recently instead begun to direct much of their monies to for-profit national managed mental health care ...

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