THE IMPACT OF MANAGED CARE ON MASSACHUSETTS MENTAL-HEALTH AND SUBSTANCE-ABUSE PROVIDERS

Medicaid managed care programs ave becoming more widespread. To invest igate the clinical, organizational and financial impacts on service pr oviders, a stratified, random sample of providers in the Massachusetts Managed Mental Health/Substance Abuse Program were surveyed by phone in Years 3 and 4 of the initiative. Providers reported that they were making widespread clinical changes such as more use of group, brief an d episodic therapies. They were increasing utilization review, Total Q uality Management, and outcomes measurement. They were increasing in s ize, affiliating with other agencies, and providing a greater range of services. They were preparing for capitation. Compared to before the program and a year earlier, about 40 percent of providers were doing b etter financially and a quarter more doing worse. The study, documents the hypothesis that a widespread and continuing transformation is tak ing place in response to managed care.