title: Some economics of mental health 'carve-outs'.
abstract: We discuss the rationale for benefit carve-out contracts in general and for mental health and substance abuse in particular. We focus on the control of adverse selection as a principal explanation and find that this is consistent with the wide-spread use of sole-source contracting with periodic rebidding. We also find that some degree of risk sharing is common; we interpret this as a method of balancing cost-containment incentives with incentives to maintain access and quality on unmeasured dimensions.
authors.affiliation: Department of Health Care Policy, Harvard School of Public Health, Boston, Mass, USA.
authors.forename: R G
authors.initials: RG
authors.lastname: Frank
authors.forename: H A
authors.initials: HA
authors.lastname: Huskamp
authors.forename: T G
authors.initials: TG
authors.lastname: McGuire
authors.forename: J P
authors.initials: JP
authors.lastname: Newhouse
mesh_terms: D002204:Capitation Fee; D003164:Competitive Bidding / Q000191:economics; D003284:Contract Services / Q000191:economics*; D017047:Cost Sharing; D006264:Health Benefit Plans, Employee / Q000191:economics / Q000458:organization & administration; D017048:Health Care Costs; D015276:Health Care Rationing; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D007358:Insurance, Psychiatric / Q000191:economics; D008329:Managed Care Programs; D008484:Medicaid / Q000191:economics; D001523:Mental Disorders / Q000191:economics* / Q000628:therapy*; D018570:Risk Assessment; D019966:Substance-Related Disorders / Q000191:economics / Q000628:therapy; D014481:United States