Date of Award

1-1980

Document Type

Thesis

Degree Name

Master of Arts

Abstract

This project examines the integration of mental health services into prepaid health care plans in St. Louis, with a focus on their role in preventive health care and cost reduction. Conducted in 1979, the study explores the philosophical and structural shifts in health care delivery, particularly the growing adoption of Health Maintenance Organizations (HMOs) and prepaid group practices. It emphasizes the evolving understanding within the medical field of the importance of psychosocial factors in health, illness prevention, and treatment outcomes.

The author, Karenlee Robinson, argues that traditional fee-for-service models often neglect the psychological components of patient care, leading to inefficiencies and increased costs. By contrast, prepaid plans that include structured mental health services are better suited to address the full spectrum of health needs, including prevention and early intervention. The study includes a literature review, outlines the economic and policy contexts prompting changes in medical practice, and discusses the benefits of incorporating short-term, goal-oriented mental health treatment into general health care.

Robinson presents data from interviews with administrators and providers from four St. Louis-based prepaid health plans—Labor Health Institute, Local 88 Medical Health Institute, Washington University’s Medical Care Group, and Medserco’s Metro Health Plan. These case studies reveal a wide variation in mental health service offerings, ranging from comprehensive services with utilization review to minimal or no preventive mental health care. The findings suggest that integrating mental health services can reduce medical costs and improve health outcomes, especially through early psychological intervention.

Ultimately, the project advocates for systemic reform in the delivery of mental health care within prepaid health models, highlighting their potential as effective, economical solutions to persistent problems in the U.S. health care system.

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