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Health Affairs, Vol 14, Issue 3, 173-184
Copyright © 1995 by Project HOPE


DataWatch

Mental health/substance abuse treatment in managed care: the Massachusetts Medicaid experience

J J Callahan, D S Shepard, R H Beinecke, M J Larson, and D Cavanaugh

Massachusetts was the first state to introduce a statewide specialty mental health managed care plan for its Medicaid program. This study assesses the impact of this program on expenditures, access, and relative quality. Over a one-year period, expenditures were reduced by 22 percent below predicted levels without managed care, without any overall reduction in access or relative quality. Reduced lengths-of-stay, lower prices, and fewer inpatient admissions were the major factors. However, for one population segment--children and adolescents--readmission rates increased slightly, and providers for this group were less satisfied than they were before managed care was adopted. Less costly types of twenty-four-hour care were substituted for inpatient hospital care. This experience supports the usefulness of a managed care program for mental health and substance abuse services, and the applicability of such a program to high-risk populations.


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