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 Scopus citations

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 1 2003

ASJC Scopus subject areas

  • Health(social science)
  • Health Policy
  • Public Health, Environmental and Occupational Health

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