Regular Articles

The Journal of Behavioral Health Services & Research

, Volume 30, Issue 2, pp 161-175

Managed care and access to substance abuse treatment services

  • Jeffrey A. AlexanderAffiliated withDepartment of Health Management and Policy, School of Public Health, University of Michigan Email author 
  • , Tammie A. NahraAffiliated withDepartment of Health Management and Policy, School of Public Health, University of Michigan
  • , John R. C. WheelerAffiliated withDepartment of Health Management and Policy, School of Public Health, University of Michigan

Rent the article at a discount

Rent now

* Final gross prices may vary according to local VAT.

Get Access

Abstract

Using nationally representative data from 1995 and 2000, this study examined how managed care penetration and other organizational characteristics were related to accessibility to outpatient substance abuse treatment. At an organizational level, access was measured as the percentage of clients unable to pay for services; the percentage of clients receiving a reduced fee; and the percentage of clients with shortened treatment because of their inability to pay. Treatment units with both relatively low and relatively high managed care penetration were more likely to support access to care; these units provided care to higher percentages of clients unable to pay and were less likely to shorten treatment because of client inability to pay. Treatment units with midrange managed care penetration were least likely to support access to care. The complexity of managing in an environment of conflicting incentives may reduce the organization's ability to serve those with limited financial means.