Care for drug or alcohol abuse is usually excluded or limited in insurance or employer mandates and parity legislation. One reason is uncertainty about the cost impact of such policies for substance abuse treatment, especially under the changes in the health care environment. To fill this informational gap, this project will study drug and alcohol abuse benefits, access to care, utilization, and costs under managed care, track changes over time, and simulate the consequences of enacting legislation for substance abuse that parallels the variety of parity efforts in mental health under way at the state level.
Its specific aims are: 1. Develop a data base of employer contracts with managed behavioral health care organizations regarding substance abuse care. Collect administrative data on enrollees, access, and claims, and structure them for quantitative analyses. Track changes in benefits related to substance abuse problems, access to care, utilization, and costs over time. 2. Study access, intensity of care, and cost patterns for substance abuse care over time and under different insurance arrangements. 3. Identify the effects of specific benefit designs (limits, deductibles, copayments) on access, intensity of care, and cost, adapting economic models of health care demand. 4. Predict the implications of substance abuse parity using parameters currently discussed for mental health care, combining the detailed models based on administrative data with information from new national surveys to make nationally representative predictions. Particular attention will be paid to differences between employed policyholders, their adult dependents, and their child dependents.
