Identifying clinical appropriateness in the catastrophic psychiatric case

The impact of private utilization management on psychiatric care: a review of the literature

Psychiatric care in the United States is increasingly practiced subject to some form of utilization management (UM) by third parties. This paper reviews recent studies of UM in the privately insured mental health sector, and finds some limited evidence that UM reduces utilization and costs to the payer. Less is known about UM's effect on mental health outcomes, or its financial impacts on patients, providers, and society. Implications concerning the regulation of UM are discussed, and suggestions are made for future research on the impact of UM.