Rapid changes in the health care system make it necessary to regularly update our knowledge of how alcohol services are provided. Health plan decisions can influence not only whether there is problem recognition, but also access to care, and the quality and cost of care received. Most people under 65 in the US, who account for the majority of persons with alcohol problems, are covered by employer-based private health insurance which influences how and what services they receive related to alcohol problems. This competitive renewal for Round 3 of our nationally representative survey of private health plans will provide a current picture of the complex and changing organization of behavioral health services in private health plans. It will build on the prior two rounds and continue explore health plan decisions about specific arrangements and to track changes in wide variety of domains. These include administrative factors, e.g., contracting arrparity law;growing role of internet and electronic health records;increased use of incentives for performance and quality;increased recognition of primary care as an essential setting for alcohol services, including brief interventions and referral and the intersection with HIV services;expansion of wellness programs and new medications for alcohol treatment. Our main objective is to further understand how alcohol services are provided in private health plans, building on and comparing with the two prior rounds.
The specific aims are: (1) Describe the provision of alcohol services in private health plans for benefit year 2010 in terms of administrative factors and clinical factors. (2) Analyze changes in health plans'provision of alcohol services in the last decade and explore factors that influence these changes. (3) Model contracting arrangements for specialty alcohol services to understand how health plan characteristics and the changing environment of service delivery withinecessary to regularly update our knowledge of how alcohol services are provided. Health plan decisions can influence not only whether there is recognition of a problem, but also patients'access to care, and the quality and cost of care they receive. This competitive renewal for Round 3 of our survey will provide a current picture of the complex and changing organization of behavioral health services in private health plans, which cover the majority of people under 65 in the U.S. ????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????????

Public Health Relevance

Rapid changes in the health care system make it necessary to regularly update our knowledge of how alcohol services are provided. Health plan decisions can influence not only whether there is recognition of a problem, but also patients'access to care, and the quality and cost of care they receive. This competitive renewal for Round 3 of our survey will provide a current picture of the complex and changing organization of behavioral health services in private health plans, which cover the majority of people under 65 in the U.S.

Agency
National Institute of Health (NIH)
Institute
National Institute on Alcohol Abuse and Alcoholism (NIAAA)
Type
Research Project (R01)
Project #
5R01AA010869-10
Application #
8318305
Study Section
Health Services Research Review Subcommittee (AA)
Program Officer
Lowman, Cherry
Project Start
1996-09-29
Project End
2014-08-31
Budget Start
2012-09-01
Budget End
2014-08-31
Support Year
10
Fiscal Year
2012
Total Cost
$670,306
Indirect Cost
$246,062
Name
Brandeis University
Department
None
Type
Schools of Social Work
DUNS #
616845814
City
Waltham
State
MA
Country
United States
Zip Code
02454
Hodgkin, Dominic; Horgan, Constance M; Quinn, Amity E et al. (2014) Management of newer medications for attention-deficit/hyperactivity disorder in commercial health plans. Clin Ther 36:2034-46
Horgan, Constance M; Garnick, Deborah W; Merrick, Elizabeth Levy et al. (2009) Changes in how health plans provide behavioral health services. J Behav Health Serv Res 36:11-24
Hodgkin, Dominic; Horgan, Constance M; Garnick, Deborah W et al. (2009) Benefit limits for behavioral health care in private health plans. Adm Policy Ment Health 36:15-23
Merrick, Elizabeth Levy; Horgan, Constance M; Garnick, Deborah W et al. (2008) Health plans'disease management programs: extending across the medical and behavioral health spectrum? J Ambul Care Manage 31:342-53
Garnick, Deborah W; Horgan, Constance M; Reif, Sharon et al. (2008) Management of behavioral health provider networks in private health plans. J Ambul Care Manage 31:330-41
Horgan, Constance M; Reif, Sharon; Hodgkin, Dominic et al. (2008) Availability of addiction medications in private health plans. J Subst Abuse Treat 34:147-56
Horgan, Constance M; Garnick, Deborah W; Merrick, Elizabeth L et al. (2007) Health plan requirements for mental health and substance use screening in primary care. J Gen Intern Med 22:930-6
Garnick, Deborah W; Horgan, Constance M; Merrick, Elizabeth L et al. (2007) Identification and treatment of mental and substance use conditions: health plans strategies. Med Care 45:1060-7
Horgan, Constance M; Merrick, Elizabeth L; Reif, Sharon et al. (2007) Internet-based behavioral health services in health plans. Psychiatr Serv 58:307
Hodgkin, Dominic; Horgan, Constance M; Garnick, Deborah W et al. (2007) Management of access to branded psychotropic medications in private health plans. Clin Ther 29:371-80

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