? ? In this renewal request for the Brandeis/Harvard Center for 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. The Brandeis/Harvard Center began in September 1995 with an award for five years of support. We are currently operating in our sixth year on a no cost extension basis. It is proposed that the Center continue with largely the same administrative structure and multidisciplinary group of researchers and educators. However, we have expanded the clinical, statistical, and methodological expertise available through the Center core. We also have expanded 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: """"""""In a managed care environment, what elements of organization, management, financing and payment make a difference in effective drug abuse service delivery?"""""""" With this theme: we have planned three projects and a pilot described briefly below: ? ? Project 1: Substance Abuse Pathways for Employee Groups. The study will use claims eligibility, authorization, and initial assessment data from Managed Health Network (MHN). In addition, the investigators will conduct a survey of patients who have received substance abuse treatment through MHN. The study will investigate whether there are differences in substance abuse utilization and costs between integrated employee assistance programs/managed behavioral health care and stand-alone component products. ? ? Project 2: Profiling and Incentives in Behavioral Health Care. This research evaluates the contribution of provider profiling 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. ? ? Project 3: Treating Nicotine Addiction in Managed Care. This observational study of 100 managed care organizations (MCOs) and 3,000 physicians will inquire into the forces that can influence MCOs to focus on treating nicotine use and addiction, and will examine how MCOs realize their potential to implement changes in the way these issues are recognized and addressed. ? ? 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 parity benefit for substance abuse treatment to private health insurance in California. ? ? OVERALL
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