There is no reward for saving money as the savings translate into a reduced next year's budget. For-profit organizations operate under a different philosophy. These organizations build capital reserves so that they can invest in the future. Managed Care Companies recognize that the best and most efficient care is that which can be crafted to meet an individual's specific needs and is flexible enough to be modified as necessary. A flexible variety of services is far superior to a limited fixed benefit.
Cost control is imposed by managing the benefit.
Cost is the driver, but service delivery is the key. Payers only want to pay a certain fixed amount for mental health services. Through competition between managed care companies service delivery becomes the key. Service delivery means eliminating artificial barriers of limited benefits, of developing organized systems of care, of public accountability, and of documented performance. Managed behavioral healthcare has come about largely because our previous way of doing things failed to solve fundamental problems related to cost, quality, access, and outcomes.