MANAGED CARE ORGANIZATIONS AND DRUG TREATMENT

描述：（申请人摘要） 行为健康管理护理组织（BHMCO）在以下方面发挥着关键作用： 药物滥用服务中的管理式护理。 这些单位有责任， 和权力，以监测和授权支付提供照顾。 然而，人们对这些单位知之甚少。 本提案旨在： 1)描述BHMCO随机样本的范围和组织; 2） 描述规则和程序的变化，或“管理式护理 机制，“BHMCO强加给供应商; 3）确定的影响， 对提供者的随机抽样服务的管理式护理机制; 4） 确定BHMCO内部和环境特征对 管理式护理机制;以及S）因此确定 BHMCO提供的服务的内部和环境特征 药物滥用提供者。 这项研究建立在药物滥用治疗系统调查的基础上， 门诊药物滥用治疗提供者纵向随机抽样。 它 将利用调查，以获得随机样本的供应商谁管理 护理合同（n=180）和管理每个此类合同的BHMCO（n-4~）。 它将在以往分析的基础上制定可靠的措施， 管理式医疗机制，包括财务风险机制， 官僚机制和治疗内容机制; BHMCO内部 和环境特征，如赞助，年龄， 竞争和外部规则。 该研究将衡量供应商 影响结果的行为：治疗持续时间、服务率 提供和获得进一步护理。 它将衡量成本和收益 管理式医疗管理 除了提供前所未有的描述 BHMCO和管理式护理安排的统计分析， 将使用多变量回归，随机回归模型和样本 选择模型：1）预测管理式护理机制的性质， BHMCO内部和环境安排; 2）确定影响 BHMCO安排的供应商的结果，好处和成本。

DESCRIPTION: (Applicant's Abstract) Behavioral Health Managed Care Organizations (BHMCOs) play a key role in managed care in drug abuse services. These units have the responsibility, and authority, to monitor and authorize payment for the provision of care. However, little is known about these units. The current proposal aims to: 1) describe the range and organization of a random sample of BHMCOs; 2) describe the variation in rules and procedures, or "managed care mechanisms," BHMCOs impose on providers; 3) determine the impact of the managed care mechanisms on the services of a random sample of providers; 4) determine the impact of BHMCO internal and environmental characteristics on the managed care mechanisms; and S) to therefore determine the impact of BHMCO internal and environmental characteristics on the services delivered by drug abuse providers. This study builds on The Drug Abuse Treatment System survey, a rigorous longitudinal random sample of outpatient drug abuse treatment providers. It will use the survey to obtain random samples of providers who have managed care contracts (n=180) and BHMCOs that administer each such contract (n-4~). It will build upon previous analyses to develop reliable measures of such factors as: managed care mechanisms, including financial risk mechanisms, bureaucratic mechanisms, and treatment content mechanisms; BHMCO internal and environmental characteristics, such as auspices, age, the degree of competition, and external regulations. The research will measure provider behaviors that affect outcomes: treatment duration, rates of service provision, and access to further care. It will measure costs and benefits of managed care administration. Beyond providing unprecedented descriptions of BHMCO and managed care arrangements in general, the statistical analyses will use multivariate regressions, random regression models, and sample selection models to: 1) predict the nature of managed care mechanisms by BHMCO internal and environmental arrangements; and 2) determine the impact of BHMCO arrangements on provider outcomes, benefits, and costs.