title: Effects of managed care on programs and practices for the treatment of alcohol and drug dependence.
abstract: Managed care is affecting the organization and financing of treatment services for alcohol and drug dependence. This paper examines the effects of managed care on program operations including the use of clinical protocols, the administrative burden, information systems, staffing, and program consolidation. It also reviews the effects of managed care on system performance related to employer-sponsored health plans, state employee health plans, and Medicaid and other public plans. Our review of managed care's influences on the alcohol and drug abuse treatment system finds evidence of systemic reductions in access to inpatient care and increased reliance on outpatient services. Moreover, although analyses of behavioral health carve-outs often suggest increases in the use of outpatient care, evaluations of substance abuse claims report reductions in ambulatory utilization for the treatment of alcohol and drug dependence.
authors.affiliation: Dartmouth Medical School, Hanover, New Hampshire 03755, USA.
authors.forename: S
authors.initials: S
authors.lastname: Steenrod
authors.forename: A
authors.initials: A
authors.lastname: Brisson
authors.forename: D
authors.initials: D
authors.lastname: McCarty
authors.forename: D
authors.initials: D
authors.lastname: Hodgkin
mesh_terms: D000437:Alcoholism / Q000191:economics / Q000534:rehabilitation*; D003363:Cost Control; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration; D006302:Health Services Research; D006801:Humans; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration*; D010343:Patient Admission / Q000191:economics; D011785:Quality Assurance, Health Care / Q000191:economics / Q000458:organization & administration; D019966:Substance-Related Disorders / Q000191:economics / Q000534:rehabilitation*; D014481:United States