Cover: Substance Abuse Service Utilization under Managed Care

Substance Abuse Service Utilization under Managed Care

HMOs versus Carve-Out Plans

Published 1999

by Bradley D. Stein, Elaine Reardon, Roland Sturm

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Managed behavioral healthcare organizations are increasingly using carve-outs to manage American's substance abuse (SA) services, but little information is available about how these changes have affected service utilization and costs when compared to HMOs. The authors compare one employer's claims for SA services delivered under a carve-out arrangement to prior HMO claims information. Under the carve-out arrangement, inpatient and outpatient service utilization decrease, but intermediate service utilization dramatically increases. Costs per unit of service decrease for all services. This pattern of changes is different from that seen for mental health services, suggesting that different factors may be applicable to substance abuse services.

Reprinted with permission from Journal of Behavioral Health Services and Research, Vol. 26, No. 4, Nov. 1999, pp. 451-456. Copyright © 1999 Sage Publications.

Originally published in: Journal of Behavioral Health Services and Research, Vol. 26, No. 4, Nov. 1999, pp. 451-456.

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