Implications of managed care for methadone treatment. Findings from five case studies in New York State

Several policy changes are being debated in New York State that may affect the financing and delivery of methadone maintenance treatment. The goals of this article are to provide greater understanding of the potential impact of managed care on methadone treatment in New York State, and greater understanding of the consequences of arbitrary limits on methadone treatment. Toward these goals, in October 1996, we conducted 1-day site visits at five methadone treatment programs in New York State to learn their views and concerns, and to examine their strategic responses to potential changes in treatment financing and delivery. The treatment programs we visited expressed concern about subjecting methadone patients to any of the potential policy changes because they felt that, if implemented without regard for the special needs of methadone patients, these reforms could hurt treatment access, retention, and quality of care. All the programs stated that limits on treatment would increase drug use and, consequently, increase crime and risk of infectious disease, and cause overall deterioration of the community.