Health Administration/Organization; Insurance; Mental Health; Substance Abuse
This Special Report of Negotiating the New Health System: A Nationwide Study of Medicaid Managed Care Contracts (2d Ed.) analyzes Medicaid managed care contract provisions related to mental illness and addiction disorders (MI/AD). The analysis is based on 54 contracts and related documents (including 12 managed behavioral health care contracts) which were in effect as of the beginning of 1997. While this Special Report considers Medicaid contracts, its findings have implications for other public purchasers of managed care services for persons with MI/AD because, like Medicaid, other sources of third-party financing have traditionally supported services and activities that may not be part of the custom of the insurance industry. If these coverage and service practices are not specified in contracts, they may be lost.
Rosenbaum, S., Shin, P., Zakheim, M., Shaw, K., Teitelbaum, J., & Johnson, K. A. (1998). Mental illness and addiction disorder treatment and prevention (Negotiating the new health system: A nationwide study of Medicaid managed care contracts [2nd ed.]). Washington, D.C.: Center for Health Policy Research, George Washington University Medical Center.