TY - JOUR
T1 - How Did the Introduction of Managed Care for the Uninsured in Iowa Affect the Use of Substance Abuse Services?
AU - Ettner, Susan L.
AU - Argeriou, Milton
AU - McCarty, Dennis
AU - Dilonardo, Joan
AU - Liu, Hui
N1 - Funding Information:
This research was funded through the Center for Substance Abuse Treatment contract no. 270-96-0002 (State Substance Abuse/Mental Health Managed Care Evaluation) between Brandeis University and the Center for Substance Abuse Treatment and the Center for Mental Health Services, under which the University of California, Los Angeles was a subcontractor. The authors gratefully acknowledge the cooperation and collaboration of state of Iowa personnel, especially Janet Zwick, Jane Gaskill, Linda Holt, Betsy Momany, Tony Davis, Dennis Petersen, and Kristie Sheakley. The content is solely the responsibility of the authors and does not necessarily reflect the official views of the Substance Abuse and Mental Health Services Administration or its components, the Center for Substance Abuse Treatment and the Center for Mental Health Services.
PY - 2003/1
Y1 - 2003/1
N2 - Concerns about access under managed care have been raised for vulnerable populations such as publicly funded patients with substance abuse problems. To estimate the effects of the Iowa Managed Substance Abuse Care Plan (IMSACP) on substance abuse service use by publicly funded patients, service use before and after IMSACP was compared; adjustments were made for changes in population sociodemographic and clinical characteristics. Between fiscal years 1994 and 1997, patient case mix was marked by a higher burden of illness and the use of inpatient, residential non-detox, outpatient counseling, and assessment services declined, while use of intensive outpatient and residential detox services increased. Findings were similar among women, children, and homeless persons. Thus, care moved away from high-cost inpatient settings to less costly venues. Without knowing the impact on treatment outcomes, these changes cannot be interpreted as improved provider efficiency versus simply cost containment and profit maximization.
AB - Concerns about access under managed care have been raised for vulnerable populations such as publicly funded patients with substance abuse problems. To estimate the effects of the Iowa Managed Substance Abuse Care Plan (IMSACP) on substance abuse service use by publicly funded patients, service use before and after IMSACP was compared; adjustments were made for changes in population sociodemographic and clinical characteristics. Between fiscal years 1994 and 1997, patient case mix was marked by a higher burden of illness and the use of inpatient, residential non-detox, outpatient counseling, and assessment services declined, while use of intensive outpatient and residential detox services increased. Findings were similar among women, children, and homeless persons. Thus, care moved away from high-cost inpatient settings to less costly venues. Without knowing the impact on treatment outcomes, these changes cannot be interpreted as improved provider efficiency versus simply cost containment and profit maximization.
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U2 - 10.1007/BF02287811
DO - 10.1007/BF02287811
M3 - Article
C2 - 12645495
AN - SCOPUS:0037270893
SN - 1094-3412
VL - 30
SP - 26
EP - 40
JO - Journal of Behavioral Health Services and Research
JF - Journal of Behavioral Health Services and Research
IS - 1
ER -