What Happens When Employers Switch from a "Carve-Out" to a "Carve-In" Model of Managed Behavioral Health?

This study examines how specialty BH care patterns change when employees and dependents are moved from a "carve-out" plan to a "carve-in" plan. METHODS: Linked insurance claims, eligibility, plan and employer data from 2008-14 were obtained for three Optum( employers who dropped their carve-out contracts but retained their carve-in plans. A longitudinal "difference-in-differences" study design was used to compare changes in BH services use over time among individuals who were: (i) moved to carve-in plans when the employer dropped its carve-out contract (N=177,653); and (ii) enrolled in carve-in plans before and after the transition (N=58,658). Outcomes included total and inpatient expenditures, broken down by plan, patient, and total; outpatient visits for assessment, individual psychotherapy, family psychotherapy, and medication management; and days of structured outpatient care, day treatment, residential care, and acute inpatient care. We pooled person-year observations and estimated regressions including individual fixed effects, year dummies and interactions between indicators for post-transition period and whether transitioned from carve-out to carve-in. RESULTS: Relative to individuals continuously in carve-in plans, those who were transitioned experienced significant increases in inpatient utilization (beta =.02; p=.05) and patient inpatient costs (beta =2.35; p=.01) and decreases in day treatment (beta =-0.01; p=.02). Our conclus...
Source: Journal of Mental Health Policy and Economics - Category: Psychiatry Tags: J Ment Health Policy Econ Source Type: research

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Source: World of Psychology - Category: Psychiatry & Psychology Authors: Tags: General Inspiration & Hope Interview Mental Health and Wellness Podcast The Psych Central Show Source Type: blogs
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Source: Expert Opinion on Pharmacotherapy - Category: Drugs & Pharmacology Tags: Expert Opin Pharmacother Source Type: research
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Source: Clinical Psychology and Psychotherapy - Category: Psychiatry Tags: Clin Psychol Psychother Source Type: research
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Source: Arts in Psychotherapy - Category: Psychiatry & Psychology Source Type: research
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Condition:   Amphetamine-Related Disorders Interventions:   Behavioral: cognitive-behavior group therapy;   Behavioral: Individual supportive psychotherapy Sponsor:   National Health Research Institutes, Taiwan Not yet recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
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