Posted by Linus on May 23, 2008, at 6:49:58
In reply to Re: Medicaid regulations - Any Comments?, posted by SLS on May 22, 2008, at 22:00:58
Thank you, for clarifying one important difference in both programs. Partial Hospitalization programs are supposed to work with the more acute populations..ie., actively psychotic individuals.
However, I think the reason why Medicaid has felt the need to issue some restrictions is because aside from actively psychotic individuals there are many consumers that are functioning at higher levels that would be very well suited in partial care programs, but have remained at Partial Hospitalization programs for years on end.
It should be the Partial Hospitalization programs responsibility to identify these individuals that are not acutely psychotic and refer them to an appropriate Partial Care Program for a cost savings to Medicaid of up to $60,000 a year per person.
In addition, a Partial Care Program will provide for clients to be seen as often as necessary by the programs Psychiatrist to accomodate medication adjustments and psychiatric intervention for the stabilization of the acute phase of an illness.
> > Program compared to that of a Partial Care Program and the services offered are very comparable.
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> Thank you for pointing out a weakness in my letter. I did not describe very well the differences between a partial hospitalization program and a partial care program.
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> They are not comparable.
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> First of all, and perhaps most importantly, a psychiatrist can be seen as often as is needed to treat an acutely ill individual. Partial care programs offer a patient an office visit with a psychiatrist once every three months.
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> > For example, a Partial Hospitalization Program can bill State Medicaid close to $400 a day,(maybe more) whereas a Partial Care Program offering similar services for a full 5 hour day is only reimbursed at a rate of $77 a day.
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> As was pointed out in the letter, it is cheaper to keep someone in a more thorough clinical treatment program than to allow for frequent hospitalizations at a cost of well over $1000 a day. It is the job of the partial care program to treat an individual so that they can remain stable enough to maintain the higher level of functioning required in a partial care facility. For instance, partial care facilities are not equipped to handle actively psychotic individuals, whether it be schizoid or manic in nature.
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> I have personally been involved in both types of programs. They are not comparable, as the goal of PH is to treat the acute illness, while PC is geared towards an individual's return to the community with the emphasis on vocational rehabilitation.
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>
> - Scott
poster:Linus
thread:826866
URL: http://www.dr-bob.org/babble/20080519/msgs/830649.html