@article{ae84d39c1f0e49bca417b9951bca2506,
title = "Public Sector Managed Care for Substance Abuse Treatment: Opportunities for Health Services Research",
abstract = "Observations of reduced utilization of alcohol and drug abuse treatment following the introduction of managed behavioral health care suggest that substance abuse services may be especially responsive to managed care restrictions and limits. In publicly funded treatment systems, patient attributes, system and provider characteristics, and financing mechanisms may heighten susceptibility to unintended effects. The State Substance Abuse and Mental Health Treatment Managed Care Evaluation Program reviewed state managed care programs for publicly funded alcohol and drug treatment services and is evaluating programs in Arizona, Iowa, Maryland, and Nebraska. The article describes initiatives and outlines evaluation activities. It discusses the opportunities and challenges of assessing public managed care plans.",
author = "Dennis McCarty and Milton Argeriou and Gabrielle Denmead and Joan Dilonardo",
note = "Funding Information: An earlier version of this article was presented at the Alcohol Services Research Conference held in Berkeley, California, in November 1997. Preparation of this article was supported by a contract from the Center for Substance Abuse Treatment (270-96-0002) and grants from the National Institute on Alcohol Abuse and Alcoholism (R01-AA-11363) and the National Institute on Drug Abuse (P50-DA-10233). The work was completed while the primary author was at Brandeis University. Funding Information: The State Substance Abuse and Mental Health Treatment Managed Care Evaluation Program was designed to review state managed care programs for publicly funded alcohol and drug abuse treatment services, assess integration with mental health managed care initiatives, analyze and evaluate program implementation in selected states, and disseminate results to policy makers. The Center for Substance Abuse Treatment (with support from the Center for Mental Health Services) within the Substance Abuse and Mental Health Services Administration contracted with Brandeis University's Schneider Institute for Health Policy and its partners Johnson, Bassin & Shaw, Inc and the Department of Health Care Policy at Harvard Medical School to design and conduct the study. During year 1, the evaluation team completed a description of state managed care programs and an analysis of the operational context in each state for its managed behavioral health care initiative. Based on this review, four states agreed to participate in a collaborative evaluation: Arizona, Iowa, Maryland, and Nebraska. The states were selected because they had comprehensive data systems, were willing to collaborate, and varied on four dimensions: the integration of mental health and substance abuse services, the inclusion of funds for non-Medicaid services, models of managed care, and statewide versus regional structures. Three of the states implemented behavioral health carve-outs for mental health and substance abuse treatment (Arizona, Iowa, and Nebraska), and one state included substance abuse treatment in the capitation for general health care (Maryland). Arizona and Iowa also expanded eligibility and services as part of their initiatives while Maryland and Nebraska did not change. State-specific evaluations were designed and implemented for each state.",
year = "2001",
month = may,
doi = "10.1007/BF02287457",
language = "English (US)",
volume = "28",
pages = "143--154",
journal = "Journal of Behavioral Health Services and Research",
issn = "1094-3412",
publisher = "Springer New York",
number = "2",
}