Public sector managed care for substance abuse treatment: Opportunities for health services research

Observations of reduced utilization of alcohol and drug abuse treatment fol lowing the introduction of managed behavioral health care suggest that subs tance abuse services may be especially responsive to managed care restricti ons and limits. In publicly funded treatment systems, patient attributes, s ystem and provider characteristics, and financing mechanisms may heighten s usceptibility to unintended effects. The State Substance Abuse and Mental H ealth Treatment Managed Care Evaluation Program reviewed state managed care programs for publicly funded alcohol and drug treatment services and is ev aluating programs in Arizona, Iowa, Maryland, and Nebraska. The article des cribes initiatives and outlines evaluation activities. It discusses the opp ortunities and challenges of assessing public managed care plans.