Drug and Alcohol Treatment Services Among Privately Insured Individuals in Managed Behavioral Health Care.

摘要

Drug and alcohol problems are a significant public health issue, affecting millions of Americans. Many of these individuals are privately insured. Private insurance coverage for substance abuse (SA) disorders has improved recently, but coverage for SA disorders remains more restricted than for other behavioral health disorders. Behavioral health benefit management has also been changing dramatically; today most privately insured individuals have their behavioral health care benefits managed separately (e.g. carved-out) from their other medical benefits. The primary goal of this dissertation is to use existing data to contribute to the empirical information available to assist decision-makers in understanding the effect of these rapid changes in the private insurance marketplace on SA treatment services. The impact of cost- sharing and different approaches to behavioral health benefit management on SA treatment service utilization was examined using two separate administrative data sets. Several analyses were conducted to examine the effects of cost- sharing across different types of SA treatment services. A separate analysis examined how utilization and costs are affected by the management of behavioral health benefits by a carve- out compared to an HMO.