State substance abuse and mental health managed care evaluation program

Area of Science:

• Behavioral Health Services Research
• Public Health Policy
• Managed Care Evaluation

Background:

• Evaluations of publicly funded managed care initiatives for substance abuse and mental health treatment were conducted.
• Four states (Arizona, Iowa, Maryland, Nebraska) participated in these initiatives.
• This overview summarizes the findings from these state-level managed care programs.

Purpose of the Study:

• To outline four managed care programs for substance abuse and mental health treatment.
• To summarize the results from evaluations of these programs.
• To identify challenges and successes in structuring managed care plans.

Main Methods:

• Utilized administrative data for program evaluations.
• Analyzed data from publicly funded managed care initiatives.
• Compared service utilization patterns across states.

Main Results:

• A continuing challenge is structuring plans to minimize adverse selection effects.
• Successful plans balanced risk and revenue, improving access to less intensive services.
• Most states observed a shift from inpatient to outpatient care.

Conclusions:

• Managed care for behavioral health requires careful structuring to mitigate adverse selection.
• Balancing financial risk with service access is key to successful programs.
• Further research using patient interviews could provide deeper insights into service quality and effectiveness.