TY  - JOUR
AU  - Brisson,Anne E.
AU  - Frank,Richard G.
AU  - Notman,Elizabeth S.
AU  - Gazmararian,Julie A.
TI  - Impact of a Managed Behavioral Health Care Carve-Out: A Case Study of One HMO
JF  - National Bureau of Economic Research Working Paper Series
VL  - No. 6242
PY  - 1997
Y2  - October 1997
UR  - http://www.nber.org/papers/w6242
L1  - http://www.nber.org/papers/w6242.pdf
N1  - Author contact info:
Richard Frank
Department of Health Care Policy
Harvard Medical School
180 Longwood Avenue
Boston, MA 02115
Tel: 617/432-0178
Fax: 617/432-1219
E-Mail: frank@hcp.med.harvard.edu
AB  - In this study we examine a case study of a carve-out for mental health and substance abuse services between a local plan of a national HMO (N=120,213) and a local managed behavioral health care vendor (MBHC). This is one of the first studies which estimates the impact of an HMO carve-out on costs and patterns of MH/SA care. Three years of insurance claims data (1993-1995) were used for the analyses, with a new carve-out contract implemented in May 1994. The new carve-out arrangement included a new vendor, a change in the organizational structure of clinical services, and increased financial risk to the vendor for inpatient care.  Descriptive and empirical analyses are reported on a continuously enrolled population (N=49,529). Results from the analyses showed the new carve-out arrangements had a significant impact on spending and utilization of services. Enrollees were 20% less likely to use MH/SA services after the implementation of the new carve-out, and inpatient MH/SA utilization dropped 50% under the new carve-out.  Overall, MH/SA spending per enrollee dropped from approximately $4.90 per month to $2.20 per month.  Outpatient MH/SA spending per user dropped 35% after the implementation of the new carve-out.  Further research should be conducted to evaluate the impact on access and quality of care, given the substantial decrease in utilization and spending.
ER  -