Selective Contracting in Managed Care: The Case of Substance Abuse Treatment

The authors address two critical questions concerning managed care and outpatient substance abuse treatment organizations. Specifically, they consider (1) to what extent selective contracting occurs between managed care firms and treatment providers and (2) what attributes of treatment providers and...

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Bibliographic Details
Published in:Medical care research and review 2001-12, Vol.58 (4), p.455-481
Main Authors: Lemak, Christy Harris, Alexander, Jeffrey A., D’Aunno, Thomas A.
Format: Article
Language:English
Subjects:
Accreditation
Ambulatory Care - organization & administration
Ambulatory Care - utilization
Biological and medical sciences
Contract Services - economics
Contract Services - standards
Contract Services - utilization
Contracting
Contracts
Cost-Benefit Analysis
Decision Making, Organizational
Economic Competition
General aspects
Health Facility Size
Health Services Research
Humans
Joint Commission on Accreditation of Healthcare Organizations
Logistic Models
Managed care
Managed Care Programs - organization & administration
Managed Care Programs - statistics & numerical data
Managed health care
Medical sciences
Methadone - therapeutic use
Ownership
Planification. Prevention (methods). Intervention. Evaluation
Public health. Hygiene
Public health. Hygiene-occupational medicine
Selective
Substance abuse
Substance abuse treatment
Substance Abuse Treatment Centers - economics
Substance Abuse Treatment Centers - standards
Substance Abuse Treatment Centers - utilization
Substance-Related Disorders - therapy
Treatment
United States
USA
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Summary:The authors address two critical questions concerning managed care and outpatient substance abuse treatment organizations. Specifically, they consider (1) to what extent selective contracting occurs between managed care firms and treatment providers and (2) what attributes of treatment providers and their operating environments are associated with selective contracting. Using data from a nationally representative sample of outpatient treatment organizations, the authors find evidence of systematic selection. Several indicators of providers’ quality and costs, including accreditation status, private ownership, size, and prior experience with managed care, are positively associated with managed care contracting. By contrast, units providing methadone treatment are less likely to be involved in managed care. To a lesser extent, characteristics of treatment providers’ operating environment, including extent of competition based on costs and attributes of the Medicaid managed care program, are also positively associated with managed care contracting.
ISSN:1077-5587
1552-6801
DOI:10.1177/107755870105800405