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Studies Differ Over Addiction Services Under Managed Care

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Two recent studies arrive at different conclusions regarding the status of addiction treatment under public-sector managed care, Alcoholism & Drug Abuse Weekly reported Oct. 30.

The national Health Care Reform Tracking Project: 1999 Impact Analysis found that managed care reforms have been inadequate in covering or making available a broad range of services for poor adolescents needing help for addictions.

“Few innovative or new adolescent-specific substance abuse treatment services have been developed as a result of managed care,” the Health Care Reform Tracking Project report stated. The report attributed the poor showing to faulty benefit design or lack of knowledge about needed services on the part of purchasers and managed-care organizations.

On the other hand, another study found that access to addiction services in one state had increased since the inception of its public managed care plan. The study, published in the Journal of the American Medical Association (JAMA), showed that access to treatment services under Oregon's managed Medicaid plan had increased between 1994 and 1998.

Luther Stohs, research analyst for the Oregon Department of Alcohol and Drug Abuse Programs, said several factors contributed to the state's success in improving access to treatment services. Among them are having many managed Medicaid health plans in the state, rather than a few larger plans; a strengthening of the existing network of treatment providers prior to the onset of managed care; and an emphasis on access.

Currently, 48 states now have managed Medicaid programs.

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