The 130th Annual Meeting of APHA

Abstract #39800

Linda E Kasten, MA, New England Research Institutes, 9 Galen Street, Watertown, MA 02472, 617-923-7747, lindak@neri.org and Michael Manocchia, PhD, Health and Lifestyle Management (BCBSRI) and The Department of Sociology (URI), Blue Cross Blue Shield of Rhode Island & The University of Rhode Island, 444 Westminster Street, Providence, RI 02903.

This research compares wrap-around services (social and health services) received by publicly funded substance abuse clients in managed care (MC) and fee-for-service (FFS) insurance programs. Within substance abuse treatment in particular, and behavioral health care in general, attention is usually paid to the client from a holistic framework. Thus wrap-around services can provide assistance in the social or physical health domains. These services and their effects would allow one to concentrate on his/her substance abuse problem, ideally leading to better treatment outcomes. We compare MC and FFS clients by the rate and type of wrap-around services received. State records of treatment received were available for 501 of the 570 subjects (88%) in the Massachusetts Managed Care Study, a study of adult substance abuse clients recruited at the beginning of a treatment episode and followed for one year. 11% received social services (legal, housing, GED, vocational, family planning, child care, job placement) and 47% received other health services (treatment for medical and/or emotional problems) within three months of their initial episode. MC clients were more likely to receive health services than FFS, and detox clients were more likely to receive social and health services than outpatient clients. Other independent predictors were higher substance use (for both social and health services) and poor self-reported health (health services only). Other demographics were examined but did not add to the prediction of service use. These results are discussed in regard to the attempt of MC systems to control cost, possibly through utilization.

Learning Objectives:

• Understand differences in managed vs fee for service systems of care.
• Distinguish between standard and extended (wrap-around) services.

Presenting author's disclosure statement:
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.