Constance M. Horgan, ScD, Schneider Institute for Health Policy, Heller Graduate School, Brandeis University, 415 South Street, MS 035, Waltham, MA 02454, 781-736-3916, horgan@brandeis.edu

Health plans have eased managed care controls in recent years, but has this more general trend in health care also occurred in behavioral health? How has the continued phenomenon of health plans carving out to specialized vendors impacted specific aspects of service provision? This session addresses how health plans provided behavioral health services in 2003 and how this changed over the previous four years. Health plan products are compared along dimensions including: prevalence of carve-outs, substance abuse benefits, network size, treatment entry practices, quality of services and utilization management techniques.

This session will consist of five papers reporting results from a nationally representative survey in 2003 of over 400 health plans in 60 market areas regarding alcohol, drug abuse and mental health services.

1 Structuring Substance Abuse Services in Health Plans (Constance M. Horgan, Deborah W. Garnick, Elizabeth Levy Merrick, Dominic Hodgkin) 2. Changes in Health Plans= Cost Sharing for Substance Abuse Services (Dominic Hodgkin, Constance M. Horgan, Deborah W. Garnick, Elizabeth Levy Merrick) 3. Selecting and Managing a Specialty Provider Network (Deborah W. Garnick, Dominic Hodgkin, Constance M. Horgan, Deborah W. Garnick, Elizabeth Levy Merrick) 4. Getting Into and Staying in Substance Abuse Treatment (Elizabeth Levy Merrick, Constance M. Horgan, Deborah W. Garnick, , Dominic Hodgkin) 5. Quality of Substance Abuse Services: Measurement and Improvement in Commercial Managed Care Plans (Joanna Volpe-Vartanian, Constance Horgan, Deborah Garnick, Elizabeth Merrick, Dominic Hodgkin).

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

• Dscribe the relevence of specific behavioral health contracting arrangements, cost-sharing requirements, network selection methods, and gatekeeping/utilization management appproaches.
• Discuss changes in these key features of managed care products since 1999.
• Describe differences inthese key features and practices based on product type and contracting arrangement.

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.