Clinically based managed mental health care.

Managed care models are on a continuum in terms of the amount of clinical involvement of the managed care agent. Managed care constitutes a fundamental shift in provider-reimburser relations. In the literature problems with managed care are identified and examined in the context of this shifting relationship. Models at three points on the continuum of clinical involvement are reviewed with regard to the identified problems, including two models with full clinical involvement. It is predicted that clinically based models will flourish and replace models with less clinical involvement because full clinical involvement solves many problems associated with other models.