title: Mental health/substance abuse treatment in managed care: the Massachusetts Medicaid experience.
abstract: Massachusetts was the first state to introduce a statewide specialty mental health managed care plan for its Medicaid program. This study assesses the impact of this program on expenditures, access, and relative quality. Over a one-year period, expenditures were reduced by 22 percent below predicted levels without managed care, without any overall reduction in access or relative quality. Reduced lengths-of-stay, lower prices, and fewer inpatient admissions were the major factors. However, for one population segment--children and adolescents--readmission rates increased slightly, and providers for this group were less satisfied than they were before managed care was adopted. Less costly types of twenty-four-hour care were substituted for inpatient hospital care. This experience supports the usefulness of a managed care program for mental health and substance abuse services, and the applicability of such a program to high-risk populations.
mesh_terms: D003363:Cost Control / Q000639:trends; D004185:Disability Evaluation; D006801:Humans; D008329:Managed Care Programs / Q000191:economics*; D008404:Massachusetts; D008484:Medicaid / Q000458:organization & administration*; D001523:Mental Disorders / Q000191:economics* / Q000534:rehabilitation; D010343:Patient Admission / Q000191:economics; D013221:State Health Plans / Q000191:economics*; D019966:Substance-Related Disorders / Q000191:economics* / Q000534:rehabilitation; D014481:United States