Administration and Policy in Mental Health and Mental Health Services Research

, Volume 33, Issue 3, pp 388–397

Schizophrenia, Co-occurring Substance use Disorders and Quality of Care: The Differential Effect of a Managed Behavioral Health Care Carve-out

  • Alisa B. Busch
  • Richard G. Frank
  • Anthony F. Lehman
  • Shelly F. Greenfield

DOI: 10.1007/s10488-006-0045-3

Cite this article as:
Busch, A.B., Frank, R.G., Lehman, A.F. et al. Adm Policy Ment Health (2006) 33: 388. doi:10.1007/s10488-006-0045-3


This study explores the differential effect of a managed behavioral health Carve-Out (CO) on outpatient treatment quality for persons with schizophrenia (SCHZ) alone and co-occurring substance use disorders (SUD) (SCHZ+SUD). We used claims data from a state Medicaid program and employed a retrospective, quasi-experimental design with logit and difference in difference formula regression models. The results show the CO was associated with greater changes in treatment quality for the SCHZ population, compared to the SCHZ+SUD population. Most pronounced across both populations were decrements in receiving the psychosocial treatments for enrollees in the CO arrangement.

Key words

Co-occurring disordersSchizophreniaSubstance use disordersQuality of careManaged care

Copyright information

© Springer Science+Business Media, Inc. 2006

Authors and Affiliations

  • Alisa B. Busch
    • 1
  • Richard G. Frank
    • 2
  • Anthony F. Lehman
    • 3
  • Shelly F. Greenfield
    • 4
  1. 1.Alcohol and Drug Abuse Treatment Program and the Department of Health Care PolicyMcLean Hospital and Harvard Medical SchoolBelmontUSA
  2. 2.Department of Health Care PolicyHarvard Medical School and National Bureau of Economic ResearchBostonUSA
  3. 3.Department of PsychiatryUniversity of Maryland School of MedicineBaltimoreUSA
  4. 4.Alcohol and Drug Abuse Treatment ProgramMcLean Hospital and Harvard Medical SchoolBelmontUSA