• Different types of managed care organizations as well as contracting arrangements will affect accessing alcohol and other drug (AOD) treatment.
• AOD treatment seeking, entry and completion are three successive but distinct stages of success.
• Introducing managed care to the Massachusetts Medicaid population reduced AOD treatment costs without arbitrarily cutting services or restricting access for disadvantaged groups.
• The American Society of Addiction Medicines Patient Placement Criteria appears to successfully match alcoholism patients to their appropriate level of care.

The term managed care continues to evoke strong opinions from patients, health-care providers, employers and insurers. Many managed care organizations (MCOs) tend to provide some degree of mental health and alcohol and other drug (AOD) treatment as part of behavioral health services. Rigorous research on AOD treatment under managed care, however, is lacking. A manuscript in the March issue of Alcoholism: Clinical & Experimental Research gathers four different study perspectives on managed-care influences on AOD treatment. The four studies were presented during a symposium at the June 2001 Research Society on Alcoholism meeting in Montreal, Quebec.

Managed care companies seem to be more accepting of mental health treatment than of AOD treatment, noted Stephen Magura, Deputy Executive Director of National Development and Research Institutes (NDRI) and lead author of the manuscript. This is largely because of the continuing development of effective medications for mental disorders that can be prescribed through the regular medical care system. AOD treatment, however, is not at this time primarily based on medications, with the rare exception such as methadone treatment for opiate addiction. AOD treatment has a greater burden of proof because it is more difficult to demonstrate the effectiveness of the more multifaceted behavioral therapies
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14-Mar-2002