State substance abuse and mental health managed care evaluation program

Special Section

Abstract

The articles in this special section of the Journal of Behavioral Health Services & Research (30:1) present results from evaluations of publicly funded managed care initiatives for substance abuse and mental health treatment in Arizona, Iowa, Maryland, and Nebraska. This overview outlines the four managed care programs and summarizes the results from the studies. The evaluations used administrative data and suggest a continuing challenge to structure plans so that undesired deleterious effects associated with adverse selection are minimized. Successful plans balanced risk with limited revenues so that they permitted greater access to less intensive services. Shifts from inpatient services to outpatient care were noted in most states. Future evaluations might conduct patient interviews to examine the effectiveness and quality of services for mental health and substance abuse problems more closely.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Institute of Medicine.Managing Managed Care: Quality Improvement in Behavioral Health. Washington, DC: National Academy Press; 1997.Google Scholar
  2. 2.
    McCarty D, Argeriou A, Denmead G, et al. Public sector managed care for substance abuse treatment.Journal of Behavioral Health Services & Research. 2001;28:143–154.Google Scholar
  3. 3.
    Mechanic D, Schlesinger M, McAlpine DD. Management of mental health and substance abuse services: state of the art and early results.The Milbank Quarterly. 1995;73:19–55.Google Scholar
  4. 4.
    Steenrod S, Brisson A, McCarty D, et al. Effects of managed care on programs and practices for the treatment of alcohol and drug dependence.Recent Developments in Alcoholism: Services Research in the Era of Managed Care. 2001;15:51–71.Google Scholar
  5. 5.
    Tompkins C, Perloff J. Using information to guide managed behavioral health care.Journal of Behavioral Health Services & Research, in press.Google Scholar
  6. 6.
    McCarty D, Argeriou M. The Iowa Managed Substance Abuse Care Plan (IMSACP): access, utilization and expenditures for Medicaid recipients.Journal of Behavioral Health Services & Research. 2003;30(1):18–25.Google Scholar
  7. 7.
    Ettner S, Argeriou M, McCarty D, et al. How did the introduction of managed care for the uninsured in Iowa affect the use of substance abuse services?Journal of Behavioral Health Services & Research. 2003;30(1):26–40.Google Scholar
  8. 8.
    American Society of Addiction Medicine.Patient Placement Criteria for the Treatment of Substance Related Disorders: ASAM PPC-2. 2nd ed. Chevy Chase, MD: American Society of Addiction Medicine; 1996.Google Scholar
  9. 9.
    Drug Strategies.Smart Steps: Treating Baltimore's Drug Problem. Washington, DC: Drug Strategies; 2000.Google Scholar
  10. 10.
    Singer J, Szanton S. Crisis of Access: How to Insure Treatment for Addiction Among Baltimore's Poor in the Age of Managed Care.The Abell Report. 1999;12(2):1–12.Google Scholar
  11. 11.
    Drug Treatment Task Force.Drug Treatment Task Force Final Report—Blueprint for Change: Expanding Access to and Increasing the Effectiveness of Maryland's Drug and Alcohol Treatment System. Annapolis, MD: State of Maryland Task Force on Drug Treatment; 2001.Google Scholar
  12. 12.
    Ettner SL, Denmead G, Dilonardo J, et al. The impact of managed care on the substance abuse treatment patterns and outcomes of Medicaid beneficiaries: Maryland's HealthChoice program.Journal of Behavioral Health Services & Research. 2003;30(1):41–62.Google Scholar
  13. 13.
    Ettner SL, Johnson S. Do adjusted clinical groups eliminate incentives for HMOs to avoid substance abusers? Evidence from the Maryland Medicaid HealthChoice program.Journal of Behavioral Health Services & Research. 2003;30(1):63–77.Google Scholar
  14. 14.
    Normand S-LT, Belanger AJ, Frank RG. Evaluating selection out of health plans for Medicaid beneficiaries with substance abuse.Journal of Behavioral Health Services & Research. 2003;30(1):78–92.Google Scholar
  15. 15.
    Bouchery E, Harwood H. The Nebraska Medicaid managed behavioral health care initiative: impacts on utilization, expenditures, and quality of care for mental health.Journal of Behavioral Health Services & Research. 2003;30(1):93–108.Google Scholar
  16. 16.
    Frank RG, McGuire TG, Bae JP, Rupp A. Solutions for adverse selection in behavioral health care.Health Care Financing Review. 1997;18:109–122.Google Scholar
  17. 17.
    Ettner SL, Frank RG, McGuire TG, et al. Risk adjustment of mental health and substance abuse payments.Inquiry. 1998;35:223–239.Google Scholar
  18. 18.
    Weisner C. The provision of services for alcohol problems: a community perspective for understanding access.Journal of Behavioral Health Services & Research. 2001;28:130–142.Google Scholar

Copyright information

© National Council for Community Behavioral Healthcare 2003

Authors and Affiliations

  • Dennis McCarty
    • 1
  • Joan Dilonardo
    • 2
  • Milton Argeriou
    • 3
  1. 1.Department of Public Health & Preventive Medicine, CB669Oregon Health & Science UniversityPortland
  2. 2.Organization and Financing Branch, Division of Services ImprovementCenter for Substance Abuse Treatment, Substance Abuse and Mental Health Services AdministrationUSA
  3. 3.Schneider Institute for Health Policy, Heller Graduate SchoolBrandeis UniversityUSA

Personalised recommendations