Tracking Changes in Behavioral Health Services. How Has Managed Care Changed Care?
Abstract
The system for providing treatment for mental health and substance abuse has changed so quickly and dramatically that research about its effects has not been able to keep up. There are few empirical studies about how managed care affects access, quality outcomes, and costs of mental health and substance abuse services. Reliable data essential for sound policy decision making. For example, in the mid-199Os, many were concerned that the costs of parity legislation (mandates requiring employers to cover mental health care at the same level as medical care) would be prohibitive. But RAND studies of managed care plans that had already implemented full parity showed that under comprehensively managed care-today's dominant arrangement-unlimited mental health benefits cost not much more than capped benefits, and substance abuse benefits were also not very costly. Parity legislation addresses nominal benefits, i.e., coverage limits, deductibles, and copayments. However, managed care can affect health care coverage in many other ways. Several new RAND studies investigate how the most common form of managed care for mental health, managed behavioral health organizations (MBHOs), has changed care, and how incentives embedded in contract design or in administrative procedures affect delivery of care in the private sector. MBHOs, which specialize in administering behavioral health benefits that have been carved out of a comprehensive health care plan, were unheard of 15 years ago. Now, MBHOs cover the majority of privately insured individuals and an increasing number of Medicaid recipients.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jan 01, 2000
- Accession Number
- ADA381409
Entities
Organizations
- RAND Corporation