Effect of a Managed Care Carve Out on Substance Abuse Treatment in Massachusetts

Abstract

As part of a study of Medicaid managed care, we surveyed a stratified random sample of 36 (out of 104) substance abuse in-patient and outpatient service providers about the Massachusetts Mental Health/Substance Abuse Program (MH/SAP), a carve out of mental health and substance abuse treatment. Despite patient advocate's fears at the start of the MH/SAP, the survey found that after four years of operation there were no significant changes in quality or outcomes compared to pre-MH/SAP. Integration between mental health and substance abuse services, effort towards quality management, the share of counselors with formal credentials, and administrative burdens on providers all increased under the program compared to the fee-for-service period. The 1996 survey, conducted just three months after the MH/SAP installed a different managed care organization as the administrator, showed that more time was needed to build confidence in the new administrator. Provider's opinions provide an informed and balanced evaluation of the achievements and challenges of a managed care program for Medicaid beneficiaries.

Key Words:

• Managed care
• substance abuse
• treatment providers
• carve out