Constance M. Horgan, ScD¹, Deborah W. Garnick, ScD¹, Dominic Hodgkin, PhD², and Elizabeth L. Merrick, PhD, MSW¹. (1) Schneider Institute for Health Policy, Heller Graduate School, Brandeis University, 415 South Street, MS 035, Waltham, MA 02454, 781-736-3916, horgan@brandeis.edu, (2) Schneider Institute for Health Policy, The Heller School for Social Policy and Management, Brandeis University, 415 South Street, MS 035, Waltham, MA 02454

Health plans have evolved in the direction of easing of managed care controls in recent years. It is not known to what extent this more general trend in health care has occurred in behavioral health. A 2003 survey on alcohol, drug abuse and mental health services yielded nationally representative data from a survey of over 400 health plans in 60 market areas. This is the second round of a telephone survey originally conducted in 1999 with a 92% response rate. We present an overview of key findings from the 2003 survey including prevalence of contracting with specialty managed behavioral health care organizations, use of risk-based contracting and covered services. We also compare these to 1999 findings which indicated that over 60% of products contracted with a specialty behavioral health vendor. We focus specifically on differences by product type (HMO, PPO, point of service) and contracting arrangement (specialty behavioral health vendor, contracted network with both general medical and behavioral health providers, internal). Early evidence from 2003 indicates that there continues to be considerable diversity in how health plans provide behavioral health services with differences by product type and contracting arrangement. Results provide a current picture of this rapidly evolving area of health care as well as a view of how key features of health plans’ managed care arrangements may have changed in four years.

Learning Objectives: At the conclusion of the session, participants will be able to

• Identify the most common behavioral health contracting arrangements for commercial managed care products.
• Discuss differences in contracting based on product type.
• Describe changes in contracting since 1999.

Keywords: Contracting, Managed Care

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.