Changes in How Health Plans Provide Behavioral Health Services

  • Constance M. Horgan
  • Deborah W. Garnick
  • Elizabeth Levy Merrick
  • Dominic Hodgkin
Regular Article


Health plans appear to be moving toward less stringent management, but it is not known whether behavioral health care arrangements mirror the overall trend. To improve access to and quality of behavioral health services, it is critical to track plans’ delivery of these services. This study examined plans’ behavioral health care arrangements and changes over time using a nationally representative health plan survey regarding alcohol, drug abuse, and mental health services in 1999 (N = 434, 92% response) and 2003 (N = 368, 83% response). Findings indicate health plans’ behavioral health service provision changed significantly since 1999, including a large increase in contracting with managed behavioral health care organizations. Some evidence of loosening administrative controls such as prior authorization implies easier access to services. However, increased prevalence of higher levels of cost sharing suggests financial barriers have grown. These changes have important implications for enrollees seeking care and for providers working to meet patients’ needs.


behavioral health managed care health plans mental health substance abuse 



The authors wish to acknowledge the contributions of Frank Potter and staff at Mathematica Policy Research, Inc. (survey design and statistical consultation, data collection), Richard Frank and Sharon Reif (comments on draft manuscript), Grant Ritter (statistical consultation), Melissa Morley, Maureen Stewart, and Joanna Volpe-Vartanian (research assistance), Galina Zolutusky (statistical programming), Michele Hutcheon and Wanda Rifkin (manuscript preparation).


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Copyright information

© National Council for Community Behavioral Healthcare 2007

Authors and Affiliations

  • Constance M. Horgan
    • 1
  • Deborah W. Garnick
    • 1
  • Elizabeth Levy Merrick
    • 1
  • Dominic Hodgkin
    • 1
  1. 1.Institute for Behavioral Health, Schneider Institutes for Health Policy, Heller School for Social Policy and ManagementBrandeis UniversityWalthamUSA

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