Oregon's transition to a managed care model for Medicaid-funded substance abuse treatment: steamrolling the glass menagerie.
The approval of a Health Care Financing Administration (now called Centers for Medicare and Medicaid Services) 1115 Medicaid waiver in Oregon allowed the state to design and implement an expanded publicly funded health care system, the Oregon Health Plan (OHP). Integral to OHP is the administration of physical and behavioral health services, including outpatient substance abuse treatment, through contracted managed care organizations. The two overarching changes to the outpatient substance abuse treatment system were expanded Medicaid eligibility and new operating procedures for the outpatient substance abuse treatment system. The authors used grounded theory to examine the effects of this transition on the treatment system, with an emphasis on the experiences of treatment providers.
D'Ambrosio
Ryan
R
RMC Research Corporation, 522 SW 5th Avenue, Suite 1407, Portland, OR 97204-2131, USA. ryan_dambrosio@rmccorp.com
Mondeaux
Frank
F
Gabriel
Roy M
RM
Laws
Katherine E
KE
D014487:Centers for Medicare and Medicaid Services, U.S.; D006302:Health Services Research; D006801:Humans; D007407:Interviews as Topic; D008329:Managed Care Programs / Q000191:economics / Q000458:organization & administration*; D008484:Medicaid / Q000191:economics / Q000458:organization & administration*; D017146:Models, Organizational; D009922:Oregon; D036301:Qualitative Research; D013221:State Health Plans / Q000191:economics / Q000458:organization & administration*; D019966:Substance-Related Disorders / Q000191:economics / Q000534:rehabilitation*; D014481:United States; D019472:Universal Health Insurance