In this revised renewal request for the Brandeis / Harvard Center on Managed Care and Drug Abuse Treatment, we propose to continue the collaboration between Brandeis University's Schneider Institute for Health Policy and Harvard Medical School's Department of Health Care Policy. We propose that the Center continue with largely the same multidisciplinary group of researchers. We have expanded the clinical, statistical, and methodological expertise available through the Center Core, as well as our emphasis on technology transfer as a core function. We propose to refine the Center's theme from a generic focus on managed care to a second generation of studies that examine the question: What elements of organization, management, financing and payment in a managed care environment make a difference in effective drug abuse service delivery? In particular, how can incentives within these areas be used to encourage or support the provision of quality drug abuse treatment services? With this theme we have planned two projects and a pilot described briefly below: Substance Abuse Pathways for Employee Groups. The study will use claims eligibility, authorization, and initial assessment data from Managed Health Network (MI-IN) to investigate whether there are differences in substance abuse utilization and costs between integrated EAP/MBHC and stand-alone component products. A survey of enrollees who are both users and nonusers of substance abuse treatment through MHN will also be conducted. Profiling and Incentives in Behavioral Health Care. This research evaluates the contribution of provider profiling and incentives to improve the quality of care. Combining a quasi-experimental interrupted time series and randomized-controlled designs, the study uses existing data from low-income general assistance clients who receive substance abuse treatment under the state of Connecticut's managed behavioral health care program. Pilot: The Effect of Parity Legislation on Substance Abuse Treatment. This pilot will explore the feasibility for a large-scale study of the incremental impact of adding a substance abuse treatment parity benefit to private health insurance in California.
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