In recent years, State Medicaid agencies and other public sector entities -- in particular, State, county, and local substance abuse and mental health (SA&MH) authorities -- have increasingly been taking the initiative to purchase SA&MH managed care (MC) services from private sector org's. or specialized nonprofit agencies. This is a practical guide for public purchasers and others involved in the design and develop. of MC initiatives involving SA&MH services. Chapters: designing, procuring, and implementing a MC system; coverage; contracting for network services; the mgmt. info. system; quality mgmt.; financial issues; and consumer protections. Bibliography.

Managed care has produced dramatic changes in the treatment of mental health and substance abuse problems, known as behavioral health. Managing Managed Care offers an urgently needed assessment of managed care for behavioral health and a framework for purchasing, delivering, and ensuring the quality of behavioral health care. It presents the first objective analysis of the powerful multimillion-dollar accreditation industry and the key accrediting organizations. Managing Managed Care draws evidence-based conclusions about the effectiveness of behavioral health treatments and makes recommendations that address consumer protections, quality improvements, structure and financing, roles of public and private participants, inclusion of special populations, and ethical issues. The volume discusses trends in managed behavioral health care, highlighting the emerging role of the purchaser. The committee explores problems of overlap and fragmentation in the delivery of behavioral health care and discusses the issue of access, a special concern when private systems are restricted and public systems overburdened. Highly applicable to the larger health care system, this volume will be of particular interest to all stakeholders in behavioral healthâ€"federal and state policymakers, public and private purchasers, health care providers and administrators, consumers and consumer advocates, accrediting organizations, and health services researchers.

Drug abuse persists as one of the most costly and contentious problems on the nation's agenda. Pathways of Addiction meets the need for a clear and thoughtful national research agenda that will yield the greatest benefit from today's limited resources. The committee makes its recommendations within the public health framework and incorporates diverse fields of inquiry and a range of policy positions. It examines both the demand and supply aspects of drug abuse. Pathways of Addiction offers a fact-filled, highly readable examination of drug abuse issues in the United States, describing findings and outlining research needs in the areas of behavioral and neurobiological foundations of drug abuse. The book covers the epidemiology and etiology of drug abuse and discusses several of its most troubling health and social consequences, including HIV, violence, and harm to children. Pathways of Addiction looks at the efficacy of different prevention interventions and the many advances that have been made in treatment research in the past 20 years. The book also examines drug treatment in the criminal justice setting and the effectiveness of drug treatment under managed care. The committee advocates systematic study of the laws by which the nation attempts to control drug use and identifies the research questions most germane to public policy. Pathways of Addiction provides a strategic outline for wise investment of the nation's research resources in drug abuse. This comprehensive and accessible volume will have widespread relevanceâ€"to policymakers, researchers, research administrators, foundation decisionmakers, healthcare professionals, faculty and students, and concerned individuals.

The primary audience for this TIP is administrators of outpatient substance abuse treatment programs. A few words about this audience are in order. Whereas TIP 8 addressed intensive outpatient treatment, the current TIP drops the word "intensive" from its title because the consensus panel hopes that this TIP will find an audience beyond administrators of IOT programs. Most of the concepts and guidelines included in this TIP apply to the administration of all substance abuse outpatient treatment (OT) programs. On those rare occasions when information applies only to IOT programs, the authors have been sure to make this clear. Although the term "administrator" is used most often to describe the audience for this book, the terms "executive" and "director" appear as well and are used interchangeably with administrator. These overlapping terms emphasize the varied roles and responsibilities that administrators assume.