Background: In 1994, by an act of law, the Puerto Rico health care system was changed to the new policy of managed care, a system that relies on providers to control expensive services, reduce cost and maintain quality of care. Whether providers achieve these goals remain unproven. Objective: To assess providers' attitudes about the effects of managed care compared with traditional care on access and quality of adolescent drug treatment. Methods: Twenty-five providers of adolescent substance abuse services were interviewed in the North Health Care Region (managed care) and Metro Region (non-managed care) in Puerto Rico. Physicians' ratings of the effects of managed care on 30 aspects of drug treatment, including access and appropriateness, resources, parental services, cost, continuity and quality of care. Results: Providers reported that managed care (compared with traditional care) had a positive impact on control of cost and appropriateness of detoxification services. However, they also felt that managed care increased work without compensation (e.g., working with parents, teachers). They also felt that managed care cut and eliminated services (e.g., residential care). However, they rated highly the requirement of trained personnel in drug treatment and the procedures for addressing grievances. They felt a great need for training programs to provide the needs of specialized personnel. Conclusions: Providers identified both positive and negative effects of managed care. Managed care requirements for trained personnel in drug abuse and mechanisms for grievances might be the paths managed care needs to improve access and quality of services.
Learning Objectives: Recognize the differences between traditional drug treatment and managed care drug treatment. Understand the attitudes of adolescent drug treatment providers towards these two systems of care
Keywords: Managed Care, Drug Abuse Treatment
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.