The main objective of this study is to understand how alcohol services are provided in health maintenance organization (HMOs) and to model decisions to provide these services internally or through a carve-out.
The specific aims for this study include the following: 1. Describe the provision of alcohol services in HMOs in terms of several factors, including overall plan and market characteristics, and characteristics of the alcohol services themselves in terms of contracting with vendors, treatment approaches, payment methods and risk sharing, utilization management, provider selection, entry into treatment, benefit. Model why some HMOs provide alcohol services internally within the plan and other HMOs choose to carve-out alcohol services to be delivered by a specialty managed behavioral health care organization. To examine questions related to these two specific aims, we will conduct a telephone survey 160 HMOs in 30 market areas. We will collaborate with the longitudinal, nationally representative Community Tracking Study (CTS) conducted by the Center for Studying Health System Change. In 30 of the same market areas as CTS and in the year following their health plan survey, we will survey a sample of the same HMOs (stratified into two groups according to how they provide alcohol services. Integrated or carve-out), regarding the provision of alcohol treatment services.
| Stewart, Maureen T; Horgan, Constance M; Hodgkin, Dominic et al. (2018) Behavioral Health Coverage Under the Affordable Care Act: What Can We Learn From Marketplace Products? Psychiatr Serv 69:315-321 |
| Garnick, Deborah W; Horgan, Constance M; Merrick, Elizabeth L et al. (2017) Private Health Plans' Contracts with Managed Behavioral Healthcare Organizations. J Behav Health Serv Res 44:149-157 |
| Reif, Sharon; Creedon, Timothy B; Horgan, Constance M et al. (2017) Commercial Health Plan Coverage of Selected Treatments for Opioid Use Disorders from 2003 to 2014. J Psychoactive Drugs 49:102-110 |
| Stewart, Maureen T; Horgan, Constance M; Quinn, Amity E et al. (2017) The Role of Health Plans in Supporting Behavioral Health Integration. Adm Policy Ment Health 44:967-977 |
| Quinn, Amity E; Reif, Sharon; Merrick, Elizabeth L et al. (2017) How Do Private Health Plans Manage Specialty Behavioral Health Treatment Entry and Continuing Care? Psychiatr Serv 68:931-937 |
| Quinn, Amity E; Reif, Sharon; Evans, Brooke et al. (2016) How health plans promote health IT to improve behavioral health care. Am J Manag Care 22:810-815 |
| Horgan, Constance M; Stewart, Maureen T; Reif, Sharon et al. (2016) Behavioral Health Services in the Changing Landscape of Private Health Plans. Psychiatr Serv 67:622-9 |
| Horgan, Constance M; Hodgkin, Dominic; Stewart, Maureen T et al. (2016) Health Plans' Early Response to Federal Parity Legislation for Mental Health and Addiction Services. Psychiatr Serv 67:162-8 |
| Reif, Sharon; Horgan, Constance M; Hodgkin, Dominic et al. (2016) Access to Addiction Pharmacotherapy in Private Health Plans. J Subst Abuse Treat 66:23-9 |
| Merrick, Elizabeth; Hodgkin, Dominic; Horgan, Constance et al. (2015) Employee assistance programs in private health plans: what do they offer? Psychiatr Serv 66:220 |
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