Outpatient-Private Practice Model

Abstract

(from the chapter) In the US, outpatient private practice emerged as a distinct model for delivering mental health services in the latter half of the 1800s. The most recent boom in outpatient private practice began during the 1960s with the passage of "freedom-of-choice" legislation requiring third-party payers to provide reimbursement for services regardless of which licensed or certified professional (e.g., psychiatrist or psychologist) delivered the services (Routh, 1994). Eventually, and not surprisingly, a tightening of the financial reigns became necessary when health care spending skyrocketed. With the rise of managed care in the 1990s, a new climate was created-a climate unsupportive of unfettered growth in the business of health care delivery. The definition and organization of the outpatient private care model, and the population served by it, are described. Additionally, the therapeutic effectiveness of the outpatient private practice model is examined. Outpatient private practice is an extremely flexible and adaptable service delivery model. The model accommodates work with children, adolescents, and families, but insurance industry policies often do not support clinically justifiable and empirically validated practices with this unique and complex population. Because private practices are self-directed, entrepreneurial enterprises, market forces will always have a significant impact on their operations, including service delivery. The mental health field's greatest challenge will be to help create an environment that supports private practitioners' desires to provide consistently high-quality, cost-effective services. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (chapter)