How Did the Introduction of Managed Care for the Uninsured in Iowa Affect the Use of Substance Abuse Services?

Susan L. Ettner, Milton Argeriou, Dennis McCarty, Joan Dilonardo, Hui Liu

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)26-40
Number of pages15
JournalJournal of Behavioral Health Services and Research
Volume30
Issue number1
DOIs
StatePublished - Jan 2003

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Managed Care Programs
managed care
substance abuse
Substance-Related Disorders
Inpatients
Outpatients
profit maximization
Social Adjustment
Homeless Persons
Cost of Illness
cost containment
Cost Control
Diagnosis-Related Groups
Vulnerable Populations
homelessness
Counseling
counseling
illness
Efficiency
Costs and Cost Analysis

ASJC Scopus subject areas

  • Health(social science)
  • Health Professions(all)

Cite this

How Did the Introduction of Managed Care for the Uninsured in Iowa Affect the Use of Substance Abuse Services? / Ettner, Susan L.; Argeriou, Milton; McCarty, Dennis; Dilonardo, Joan; Liu, Hui.

In: Journal of Behavioral Health Services and Research, Vol. 30, No. 1, 01.2003, p. 26-40.

Research output: Contribution to journalArticle

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