The 130th Annual Meeting of APHA

Abstract #46413

Joseph P. Morrissey, PhD¹, Kathleen C. Thomas, PhD¹, Thomas D'Aunno, PhD², Kathleen Holladay³, and Daniel Lee, PhD³. (1) Cecil G. Sheps Center for Health Services Research, University of North Carolina, Chapel Hill, 101 Conner Dr. Ste.302, Willowcrest Bldg., CB#3386, Chapel Hill, NC 27599, (2) School of Social Service Administration, University of Chicago, 969 E. 60th Street, Chicago, IL 66037, (3) Cecil G. Sheps Center for Health Services Research, University of North Carolina Chapel Hill, 101 Conner Dr. Ste.302, Willowcrest Bldg., CB#3386, Chapel Hill, NC 27599

Substance abuse services are most effective for persons with co-occurring disorders if they receive a broad range of services concomitantly. Managed care, with its practices of decreasing services use and refining provider networks, may have the consequence of disrupting the local service system of care. This study collects data from 228 service providers in 62 sites across the US. In each site, one outpatient substance abuse agency is asked to identify up to six other local providers of mental health or primary care that are important for their clients, along with attributes of their organization and service relationships. These other identified organizations are asked a similar set of questions. Results indicate that service networks are sparse, with just over 3 relationships on average. Most service relationships are set up at the two extremes of formality, being either the result of a common parent agency or an informal arrangement, with few taking the middle ground. Substance abuse agencies report that managed care has not affected these relationships much. However, they report that inadequate insurance reimbursement is a major barrier to maintaining good working relationships. Analyses will include interorganizational network methods and dyadic analysis of the relationships between substance abuse providers and other local providers of supportive care. Analyses will be used to assess these relationships and to determine the impact of managed care on them. Results have important policy implications for supporting coordinated care for persons with substance abuse and co-occurring disorders.

Learning Objectives:

• Describe the number and characteristics of substance abuse service relationships with mental health and primary care providers.
• Discuss important barriers to substance abuse service relationships.
• Assess the variation in service relationships by level of managed care as well as the perceived impact of managed care on those service relationships.

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.