Quality Measurement and Accountability for Substance Abuse and Mental Health Services in Managed Care Organizations

Bibliographic Data

ID9101201
AuthorsElizabeth Levy Merrick (Brandeis University), Deborah W Garnick (0000-0002-9417-118X, Brandeis University), Constance M Horgan (0000-0002-2659-7082, Brandeis University), Dominic Hodgkin (0000-0002-4494-9176, Brandeis University)
Year2002
Volume40
Issue12
Pages1238-1248
Publication date2002-12-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-200212000-00010
PMID12458305
OpenAlexW2012700068
LanguageEN
Citations received3
References cited17

OBJECTIVES: To analyze managed care organizations' (MCOs') use of behavioral health quality management activities using nationally representative survey data. MATERIALS AND METHODS: The primary data source is the Brandeis Survey on Alcohol, Drug Abuse, and Mental Health Services in MCOs. Using a sampling strategy designed for national estimates, we surveyed 434 MCOs in 60 market areas (response rate = 92%) regarding their commercial products' behavioral health services in 1999. Of these, 417 MCOs reported clinically oriented information for 752 products. We investigated the use of four behavioral health quality management activities: patient satisfaction surveys, clinical outcomes assessment, performance indicators, and practice guidelines. chi tests and logistic regression were used to determine effects of product type (HMO, PPO, point-of-service) and behavioral health contracting arrangement (specialty contract, comprehensive contract including general medical and behavioral health, internal provision). RESULTS: Three-quarters of products used patient satisfaction surveys (70.1%), performance indicators (72.7%), and practice guidelines (73.8%) for behavioral health. Under half (48.9%) assessed clinical outcomes. HMO products were most likely, and PPOs least likely, to conduct activities. Quality activities were significantly more common among specialty-contract products. Logistic regression showed significant negative effects on quality activity use for PPO and POS products compared with HMOs. For clinical outcomes, specialty- and comprehensive-contract arrangements had significant positive effects. There were interactions between product type and contract arrangement. CONCLUSIONS: Most commercial managed care products use patient satisfaction surveys, performance indicators, and practice guidelines for behavioral health, whereas clinical outcomes assessment is less common. Product type and contracting arrangements significantly affect use of these activities

Business · Environmental health · Family medicine · Health care · Logistic regression · Managed care · Mental health · Psychiatry · Quality (philosophy) · Specialty · Utilization management · Healthcare Policy and Management · Medicine · Patient Satisfaction in Healthcare · Pharmaceutical industry and healthcare