Abstract: This paper provides current insights into factors that influence how publicly-funded adolescents gain access to substance abuse services under Massachusetts’ Medicaid managed care, paying particular attention to regional/ geographic differences. This study is part of a larger three year study examining the impact of managed care on service utilization, cost of services, and effectiveness of care on outcomes for these adolescents.
This is a qualitative analysis based on 42 semi-structured interviews and 2 provider focus groups. The interviews were conducted with state agency officials at the state, regional and area levels and were carried out between July 1999 and December 1999. Regional and area levels were classified according to urban or rural.
We identified two main geographical differences that influenced access to care: (1) Knowledge in accessing services. Agencies situated in urban areas had better knowledge of how to go about accessing services and had greater success in obtaining them. (2) Coordination of services. Better communication lines existed between agencies in urban than in rural areas. However, informants state-wide expressed difficulty in accessing mental health services for kids dually diagnosed for substance abuse and mental health.
Our findings suggest that within the managed care system, gaining access into treatment for publicly-funded adolescents has been regionally sensitive, with rural areas having more difficulty in accessing services than urban. This suggests that a more uniform dispersion of knowledge of how to access services and better coordination across agencies needs to be addressed in order to circumvent urban bias in accessing services.
Learning Objectives: Participants will gain a current perspective on the regionally sensitive nature of how publicly-funded adolescents gain access to services under Massachusetts' managed care model
Keywords: Access, Adolescents
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.