Managed care organizations' use of treatment management strategies for outpatient mental health care
Abstract
A nationally representative sample of managed care organizations was surveyed (response rate=92%) regarding use of treatment management techniques for outpatient mental health care in their commercial products in 1999. Bivariate tests and logistic regression models were used to examine the relationship between product type, behavioral health contracting arrangement and treatment management techniques (prior authorization, standards for time to initial appointment, concurrent review, standards for follow-up after discharge, case management, practice guidelines). Prevalence varied from 43% to 87% depending on the technique. HMO products and products with specialty behavioral health contracts were more likely to use the techniques. Product type and contracting arrangement had independent effects.
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Behavioral health insurance benefits have historically been less generous than insurance benefits for medical and surgical care in the employer-sponsored insurance market.
“Despite the fact that health insurance is supposed to protect individuals from financial shocks associated with healthcare expenses, behavioral health (BH) insurance benefits, which cover MH and SUD services, have historically been less generous than insurance benefits for medical and surgical care in the employer-sponsored insurance market (Barry et al., 2003; Hodgkin, Horgan, Garnick, & Merrick,”
From The Mental Health Parity and Addiction Equity Act evaluation study: Impact on specialty behavioral healthcare utilization and spending among enrollees with substance use disorders (2017) · cites this paper as Merrick, Horgan, Garnick, & Hodgkin, 2006
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References 41 · Cited by 9
- Authors
- Merrick, E. L., Horgan, C. M., Garnick, D. W., & Hodgkin, D.
- Affiliations
- Brandeis University (US)
- Corresponding author
- Merrick, Elizabeth Levy
- Venue
- Administration and Policy in Mental Health and Mental Health Services Research
- Published
- 2005-12-30
- Volume
- 33
- Issue
- 1
- Pages
- 104-14
- ISSN
- 0894-587X (ISSN-L)
- 1573-3289
- OpenAlex
- W2075400616
- Cited by
- 9
- References
- 41
- Citations by year
- 2019: 1 · 2017: 3 · 2012: 1
- FWCI
- 2.46
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Administration and Policy in Mental Health and Mental Health Services Research (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Alcohol Abuse and Alcoholism (R01AA010869, R01-AA-10869)
- National Institute on Drug Abuse (R01DA010915, R01 DA10915)
- Topics
- Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Healthcare Policy and Management
- Social Sciences › Psychology › Clinical Psychology › Psychiatric care and mental health services
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- managed care organizations, outpatient psychiatric care, prior authorization, concurrent review, case management, clinical guidelines, HMOs, post-discharge follow-up
- MeSH terms
- Ambulatory Care, Mental Disorders, Humans, Managed Care Programs, Patient Care Management, United States, Health Care Surveys
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