Issues Paper

Denise Turner

Managed Care and Health Insurance

HSM 420

Professor Sonya Beard

February 22, 2009
Issues Paper

Western Psychiatric Institute and Clinic is a large psychiatric clinical facility that centers its services around social, biological, addictive, and psychological treatments (Mezzich, 1985). For more than 50 years it has serviced Western Pennsylvania with state-of-the art quality care to patients of all ages (Western psychiatric institute & clincic, 2009). It is a large facility that makes up one of 20 hospitals and facilities of UPMC’s vast Pennsylvanian hospitals. UPMC belongs to the University of Pittsburgh and does not publicize its annual report. It is a non-profit hospital system that is accredited by JCAHO(formerly called Joint Commission on Accreditation of Healthcare Organizations), now known as the Joint Commission (Western psychiatric institute & clinic, 2009). Even with that accreditation the issue of quality of care has crossed the mind of many over this past year after the Pittsburgh Post Gazette’s fall issues have focused on a significant amount of crimes committed by those who frequent the hospital’s services. Though quality of care can best be discussed by a professional clinician, psychologist, or financial representative, I as a student would like to focus on the aspect of length of stay as a deterrent to repeated offenses among psych patients. But first we should consider aspects of managed care organizations and quality of care; as well as the facts. What crimes took place in Pennsylvania? How were they handled? Why would longer stays in the hospital be helpful? This paper demonstrates my attempt to answer these questions. Through my experience as a patient registrar at Western Psych Institute and Clinic many managed care organizations are third party payers of both inpatient and outpatient